Individual provider · NPI-1

Shakespeare Acevedo Perez, SA-C

Physician Assistant, Surgical · Houston, TX

NPI number1013764661

StatusActive

Last updated in NPPESNov 6, 2024

Details

NPI: 1013764661
Entity type: Individual (NPI-1)
Name: Shakespeare Acevedo Perez
Credential: SA-C
Sex: Male
Sole proprietor: Yes
Enumeration date: May 2, 2024
Certification date: Nov 6, 2024
Last updated: Nov 6, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363AS0400X	Physician Assistant, Surgical	SA00941	TX	Yes
246ZC0007X	Specialist/Technologist, Other, Surgical Assistant	21-379	TX

Practice location

4120 Southwest Fwy Ste 230
Houston, TX 77027-7327

Phone 281-254-8206

Mailing address

7606 Chasecreek Dr
Missouri City, TX 77489-1874

Phone 346-901-4971

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