NPIMap

Organization Active NPI

Erica Ann. Perez, PHD. PC

  • Psychologist
  • Edinburg, TX
National Provider Identifier
1659876803
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
36221 Issued in TX
Legal business name
ERICA ANN. PEREZ, PHD. PC
Practice address
402 N Jackson Rd
Edinburg, TX 78541-2868
Phone
(956) 540-7509
Fax
(956) 540-7510
NPI assigned
Mar 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Erica A. Perez, PHDNPI 1356694145
Title
Owner
Phone
(956) 540-7509

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 36221 TX Primary
Group Psychotherapy PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TP2701X

Addresses

Primary practice location

402 N Jackson Rd
Edinburg, TX 78541-2868

Mailing address

402 N Jackson Rd
Edinburg, TX 78541-2868
Phone (956) 540-7509

Other identifiers 1

IdentifierTypeStateIssuer
4115909-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180813000984 TX Part B Supplier - Clinic/Group Practice 0244588986 Receives reassigned benefits from 9 practitioners
Practice locations: Edinburg, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1659876803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N JACKSON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785412868",
            "telephone_number": "956-540-7509",
            "fax_number": "956-540-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N JACKSON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785412868",
            "telephone_number": "956-540-7509",
            "fax_number": "956-540-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA ANN. PEREZ, PHD. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-540-7509",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36221",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4115909-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.