Provider Demographics
NPI:1174947857
Name:PERES HOLDINGS LLC
Entity type:Organization
Organization Name:PERES HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PERES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-725-4249
Mailing Address - Street 1:505 W FAIRMONT PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-6312
Mailing Address - Country:US
Mailing Address - Phone:713-725-4249
Mailing Address - Fax:
Practice Address - Street 1:505 W FAIRMONT PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-6312
Practice Address - Country:US
Practice Address - Phone:713-725-4249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79417363L00000X
TX10309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty