Provider Demographics
NPI:1649458944
Name:PEREZ, RAUL (LHAS)
Entity type:Individual
Prefix:MR
First Name:RAUL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:LHAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3635
Mailing Address - Country:US
Mailing Address - Phone:810-733-1060
Mailing Address - Fax:810-732-5020
Practice Address - Street 1:1026 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3635
Practice Address - Country:US
Practice Address - Phone:810-733-1060
Practice Address - Fax:810-732-5020
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501004430237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist