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Individual

LETICIA R. PEREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPAS, PA

Contact information

Practice address
2800 S INTERSTATE 35 STE 103, AUSTIN, TX 78704-5700
(512) 826-0773
(833) 938-5463
Mailing address
2800 S INTERSTATE 35 STE 103, AUSTIN, TX 78704-5700
(512) 826-0773
(833) 938-5463

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA04895
TX
363AM0700X
Medical Physician Assistant
Primary
PA04895
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA04895
TEXAS MEDICAL LIC.
TX
Enumeration date
10/31/2006
Last updated
05/23/2023
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