Individual provider Active NPI

Teshara Perez, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1083165906
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP132271 Issued in TX
Practice address
4321 Marsha Sharp Fwy
Lubbock, TX 79407-2504
Phone
(806) 686-3500
Fax
(806) 701-4973
NPI assigned
Oct 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP132271 TX Primary

Addresses

Primary practice location

4321 Marsha Sharp Fwy
Lubbock, TX 79407-2504

Mailing address

4324 23Rd St
Lubbock, TX 79410-1812
Phone (806) 701-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123000113 TX Practitioner - Nurse Practitioner 9739461229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Heart and Vascular PLLCGroup PAC ID 6305297763, 4 clinicians

Practice addresses (Care Compare)

4321 Marsha Sharp Fwy
Lubbock, TX 79407-2504
Phone (806) 701-4263

Hospital & facility affiliations

  • Lubbock Heart Hospital LP Hospital, Lubbock, TX, CCN 450876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132271TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Heart & Vascular, PLLC CurrentSince Jan 1, 2024 Accepting new patients
Caprock Cardiovascular Center, LLP Current Accepting new patients

Locations

4316 23rd St
Lubbock, TX 79410
Phone (806) 516-5922

4321 Marsha Sharp Fwy
Lubbock, TX 79407
Phone (806) 701-5858

4324 23rd St
Lubbock, TX 79410
Phone (806) 701-4263

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1083165906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 23RD ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101812",
            "telephone_number": "806-701-4263",
            "fax_number": "806-701-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072504",
            "telephone_number": "806-686-3500",
            "fax_number": "806-701-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "TESHARA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.