Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 569599 | TX |
NPI | 1164864898 |
---|---|
Provider Name | Annette Jeanne Perez |
First Address | El Paso, TX 79905-2709 |
Second Address | El Paso, TX 79905-2709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2013 |
Last Update Date | 23/07/2013 |