Individual provider Active NPI

Brenda Selene Perez

  • Family Nurse Practitioner
  • McAllen, TX
National Provider Identifier
1104334192
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142519 Issued in TX
Practice address
1309 S 10TH St
McAllen, TX 78501-5023
Phone
(956) 360-7889
Fax
(956) 800-5311
NPI assigned
Jan 12, 2018
Reactivated
Feb 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 780789 TX
Family Nurse Practitioner 363LF0000X AP142519 TX Primary

Addresses

Primary practice location

1309 S 10TH St
McAllen, TX 78501-5023

Mailing address

306 E Sabatina Ave
Pharr, TX 78577-7824
Phone (956) 360-7889

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
I20191115000361 TX Practitioner - Nurse Practitioner 5092078477 Practice locations: McAllen, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
780789TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medi-Lab Medical Equipment LLC Durable Medical Equipment & Medical Supplies CurrentSince Dec 14, 2017 Accepting new patients
Medi-Lab Provider Services LLC Current Accepting new patients

Locations

4301 N 22nd St
Ste A
McAllen, TX 78504
Phone (956) 800-5008

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.

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1104334192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E SABATINA AVE",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785777824",
            "telephone_number": "956-360-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S 10TH ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785015023",
            "telephone_number": "956-360-7889",
            "fax_number": "956-800-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "BRENDA",
        "middle_name": "SELENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "deactivation_date": "2018-08-01",
        "reactivation_date": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "780789",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.