Provider Demographics
NPI:1932677051
Name:DOOLING PEREZ, ELIZABETH DANIELLE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DANIELLE
Last Name:DOOLING PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 BRIXTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-6680
Mailing Address - Country:US
Mailing Address - Phone:956-537-6899
Mailing Address - Fax:
Practice Address - Street 1:7060 CAMP BOWIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7119
Practice Address - Country:US
Practice Address - Phone:214-865-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX408622355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No251E00000XAgenciesHome Health