Individual provider Active NPI

Anthony Manuel Perez, MD

  • Internal Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1174198485
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
W7107 Issued in TX
Practice address
5203 Lake Ridge Pkwy
Grand Prairie, TX 75052-3010
Phone
(817) 633-9590
NPI assigned
May 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X W7107 TX Primary

Addresses

Primary practice location

5203 Lake Ridge Pkwy
Grand Prairie, TX 75052-3010

Mailing address

5203 Lake Ridge Pkwy Ste 101
Grand Prairie, TX 75052-3017
Phone (817) 633-9590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630002479 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1951760479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: anthony.perezsantos@hca4.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1174198485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 LAKE RIDGE PKWY STE 101",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523017",
            "telephone_number": "817-633-9590",
            "fax_number": "833-419-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 LAKE RIDGE PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523010",
            "telephone_number": "817-633-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ANTHONY",
        "middle_name": "MANUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "W7107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.