Provider Demographics
NPI:1467461350
Name:PEREZ-LYKOS, JANET L (FNP)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:L
Last Name:PEREZ-LYKOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4833 S STAPLES
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-225-2271
Mailing Address - Fax:361-225-2273
Practice Address - Street 1:4833 S STAPLES
Practice Address - Street 2:SUITE #1
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-225-2271
Practice Address - Fax:361-225-2273
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX606848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167212301Medicaid
Q14696Medicare UPIN
TX167212301Medicaid