Provider Demographics
NPI:1649880071
Name:PEREZ, ANISA
Entity type:Individual
Prefix:
First Name:ANISA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CHAPMAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-7914
Mailing Address - Country:US
Mailing Address - Phone:956-456-2644
Mailing Address - Fax:
Practice Address - Street 1:2117 E TYLER AVE STE B
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7212
Practice Address - Country:US
Practice Address - Phone:956-440-0580
Practice Address - Fax:956-440-0584
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist