Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 107801 | TX |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 107801 | TX |
NPI | 1285819797 |
---|---|
Provider Name | Mr. Rene Alcee Pere |
First Address | Round Rock, TX 78664-2351 |
Second Address | Round Rock, TX 78664-2351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2008 |
Last Update Date | 02/01/2008 |