Provider Demographics
NPI:1073337515
Name:PEREZ, ROGELIO SR
Entity type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name:PEREZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ROGER
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4502 ALBERT MARTIN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5084
Mailing Address - Country:US
Mailing Address - Phone:210-426-1599
Mailing Address - Fax:210-684-6464
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693903163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse