Active NPI
Ethan Nathaniel Perez
- Athletic Trainer
- Houston, TX
National Provider Identifier
1801582747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 43887642
- Practice address
- 13711 Chester Gables CT
Houston, TX 77083-6089 - Phone
- (713) 382-1190
- NPI assigned
- Apr 13, 2023
- Last updated
- Apr 13, 2023
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 43887642 | TX | Primary |
Addresses
Primary practice location
13711 Chester Gables CT
Houston, TX 77083-6089
Mailing address
13711 Chester Gables CT
Houston, TX 77083-6089
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 |
|---|---|---|---|
| 43887642 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681344000000",
"number": "1801582747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13711 CHESTER GABLES CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770836089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13711 CHESTER GABLES CT",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770836089",
"telephone_number": "713-382-1190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "ETHAN",
"middle_name": "NATHANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-13",
"last_updated": "2023-04-13",
"certification_date": "2023-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "43887642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.