Provider Demographics
NPI:1144501321
Name:PERALES, GILBERT L (MOT, OTR/L)
Entity type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:L
Last Name:PERALES
Suffix:
Gender:M
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 PUESTA DE SOL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2415
Mailing Address - Country:US
Mailing Address - Phone:210-544-2630
Mailing Address - Fax:
Practice Address - Street 1:3550 PUESTA DE SOL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2415
Practice Address - Country:US
Practice Address - Phone:210-544-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist