Organization
J.I. PERALES MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE I PERALES MD (PRESIDENT)
(806) 273-7118
Entity
Organization
Contact information
Practice address
202 S MCGEE ST, BORGER, TX 79007-4022
(806) 273-7118
Mailing address
PO BOX 3188, BORGER, TX 79008-3188
(806) 273-7118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E3403
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QB44
BLUE CROSS
—
Enumeration date
06/25/2006
Last updated
09/26/2007
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