Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 04-29758 | KS |
Y | 208600000X | Surgeon | 04-29758 | KS |
N | 2086S0122X | Plastic and Reconstructive Surgery | 04-29758 | KS |
NPI | 1225142532 |
---|---|
Provider Name | Dr. Victor Manuel Perez SR. |
First Address | Overland Park, KS 66223-2907 |
Second Address | Overland Park, KS 66223-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 17/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100421060A | (05) | KS |
H62187 | (02) | KS |