Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | M6826 | TX |
NPI | 1003010687 |
---|---|
Provider Name | Anthony Joseph Perri III |
First Address | Houston, TX 77253-3265 |
Second Address | Conroe, TX 77304-5076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 26/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197963502 | (05) | TX |