Provider Demographics
NPI:1386958858
Name:PEREZ ENRIQUEZ, JOSE NATIVIDAD (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:NATIVIDAD
Last Name:PEREZ ENRIQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 E PRICE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3508
Mailing Address - Country:US
Mailing Address - Phone:956-545-0080
Mailing Address - Fax:956-545-0071
Practice Address - Street 1:58 E PRICE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3508
Practice Address - Country:US
Practice Address - Phone:956-545-0080
Practice Address - Fax:956-545-0071
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine