Provider Demographics
NPI:1457722035
Name:PEREZ, APOLINIO RAUL (LMT)
Entity type:Individual
Prefix:
First Name:APOLINIO
Middle Name:RAUL
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:APOLINIO
Other - Middle Name:RAUL
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:25815 SILVER TIMBERS LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0727
Mailing Address - Country:US
Mailing Address - Phone:713-575-0665
Mailing Address - Fax:
Practice Address - Street 1:25815 SILVER TIMBERS LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0727
Practice Address - Country:US
Practice Address - Phone:713-575-0665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMT 109023225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist