Provider Demographics
NPI:1750390605
Name:PEREZ, JOSEPH REGINALD (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:REGINALD
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:14090 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3677
Mailing Address - Country:US
Mailing Address - Phone:281-645-6401
Mailing Address - Fax:281-277-8872
Practice Address - Street 1:14090 SOUTHWEST FWY
Practice Address - Street 2:SUITE 306
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3677
Practice Address - Country:US
Practice Address - Phone:281-645-6401
Practice Address - Fax:281-277-8872
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK8965207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH15020Medicare UPIN
TX8F0680Medicare PIN