Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | L1692 | TX |
Y | 207YP0228X | Pediatric Otolaryngology | L1692 | TX |
NPI | 1902840929 |
---|---|
Provider Name | Kevin D Pereira |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 11/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
125231401 | CSHCN (01) | TX |
125231404 | (05) | TX |
87X535 | BCBS (01) | TX |
G48425 | (02) | TX |