Provider Demographics
NPI:1316620461
Name:PEREZ, LIVIA (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:LIVIA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WHISPERING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-6210
Mailing Address - Country:US
Mailing Address - Phone:469-417-9480
Mailing Address - Fax:
Practice Address - Street 1:5959 ROYAL LN STE 530
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-7802
Practice Address - Country:US
Practice Address - Phone:972-707-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130834363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner