Provider Demographics
NPI:1285690768
Name:PEREZ, TESSA V (MD)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:V
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3533 S ALAMEDA ST
Mailing Address - Street 2:SUITE 303-JOSEPH SLOAN MEDICAL CENTER
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-853-3222
Mailing Address - Fax:361-561-2692
Practice Address - Street 1:3401 AVENUE E
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6561
Practice Address - Country:US
Practice Address - Phone:406-281-8700
Practice Address - Fax:406-281-8708
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-01-09
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Provider Licenses
StateLicense IDTaxonomies
TXL4641208000000X
MT100592208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL4641OtherTEXAS LICENSE
TX171461301Medicaid
TX60125376OtherDPS
TX171761302Medicaid
TXBP7935426OtherDEA