Provider Demographics
NPI:1780873786
Name:PEREZ, SIGIFREDO JR (PTA)
Entity type:Individual
Prefix:MR
First Name:SIGIFREDO
Middle Name:
Last Name:PEREZ
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-8702
Mailing Address - Country:US
Mailing Address - Phone:956-630-0836
Mailing Address - Fax:956-630-0836
Practice Address - Street 1:600 N CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8702
Practice Address - Country:US
Practice Address - Phone:956-630-0836
Practice Address - Fax:956-630-0836
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2063200225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant