Active NPI
Juan R Perez, LPC
- Professional Counselor
- Grand Prairie, TX
National Provider Identifier
1083779631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7738
- Practice address
- 620 W Westchester Pkwy Apt 2207
Grand Prairie, TX 75052-3268 - Phone
- (469) 682-8046
- Fax
- (972) 266-0072
- NPI assigned
- Dec 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7738 | TX | Primary |
Addresses
Primary practice location
620 W Westchester Pkwy Apt 2207
Grand Prairie, TX 75052-3268
Mailing address
620 W Westchester Pkwy Apt 2207
Grand Prairie, TX 75052-3268
Phone (469) 682-8046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7738 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1083779631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 W WESTCHESTER PKWY APT 2207",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750523268",
"telephone_number": "469-682-8046",
"fax_number": "972-266-0072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 W WESTCHESTER PKWY APT 2207",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750523268",
"telephone_number": "469-682-8046",
"fax_number": "972-266-0072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JUAN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "7738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.