Provider Demographics
NPI:1952979437
Name:PEREZ, RAFAEL JR (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:PEREZ
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-4902
Mailing Address - Country:US
Mailing Address - Phone:956-297-0409
Mailing Address - Fax:
Practice Address - Street 1:1800 S 5TH ST STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2909
Practice Address - Country:US
Practice Address - Phone:956-971-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1351952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist