Provider Demographics
NPI:1164384046
Name:PEREZ, CIARA BREANNA (MT)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:BREANNA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SALLY LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-9414
Mailing Address - Country:US
Mailing Address - Phone:956-493-8906
Mailing Address - Fax:
Practice Address - Street 1:117 SALLY LN
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-9414
Practice Address - Country:US
Practice Address - Phone:956-493-8906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-29
Last Update Date:2025-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT11169225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty