Provider Demographics
NPI:1578449971
Name:PEREA, OSCAR
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:PEREA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 TRUSLER RD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1533
Mailing Address - Country:US
Mailing Address - Phone:817-696-1935
Mailing Address - Fax:
Practice Address - Street 1:9712 TRUSLER RD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-1533
Practice Address - Country:US
Practice Address - Phone:817-696-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant