Provider Demographics
NPI:1174165351
Name:MARTEL PEREZ, JUAN F
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:F
Last Name:MARTEL PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 STEVE DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-1396
Mailing Address - Country:US
Mailing Address - Phone:817-880-9184
Mailing Address - Fax:
Practice Address - Street 1:909 GRANBURY ST STE A
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-5711
Practice Address - Country:US
Practice Address - Phone:817-880-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant