Individual
DR. LAURENCE PETER PEROTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
BROOKE ARMY MEDICAL CENTER, 3551 ROGER BROOKE DR., FT. SAM HOUSTON, TX 78234
(210) 539-9567
(210) 539-6467
Mailing address
4006 BENTWAY ST, SAN ANTONIO, TX 78217-1705
(210) 310-8864
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2-2336
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000G497
BLUE CROSS BLUE SHIELD PR
TX
Enumeration date
12/28/2005
Last updated
12/05/2019
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