Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 7179 | TX |
NPI | 1003249699 |
---|---|
Provider Name | Dr. Tom E Perez III |
First Address | Houston, TX 77077-5536 |
Second Address | Houston, TX 77077-5536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2013 |
Last Update Date | 19/08/2013 |