Provider Demographics
NPI:1184685109
Name:PEREZ, JOHN ARTHUR (PA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ARTHUR
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-5141
Mailing Address - Country:US
Mailing Address - Phone:830-278-5604
Mailing Address - Fax:830-278-1836
Practice Address - Street 1:700 S FRIO
Practice Address - Street 2:
Practice Address - City:CAMP WOOD
Practice Address - State:TX
Practice Address - Zip Code:78833
Practice Address - Country:US
Practice Address - Phone:830-278-5604
Practice Address - Fax:830-278-1836
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03930363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA03930OtherPHYSICIAN ASSISTANT PERMI