Individual
DERICA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APPMHNP
Contact information
Practice address
4645 SAMUELL BLVD, DALLAS, TX 75228-6826
(214) 275-7393
Mailing address
4645 SAMUELL BLVD, DALLAS, TX 75228-6826
(214) 275-7393
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP130069
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/01/2015
Last updated
03/04/2021
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