Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | J0192 | TX |
N | 208600000X | Surgeon | J0192 | TX |
Y | 2086X0206X | Surgical Oncologist | J0192 | TX |
NPI | 1174592430 |
---|---|
Provider Name | Dr. Kerri Lynn Perry |
First Address | Dallas, TX 75391-1230 |
Second Address | Denton, TX 76201-4315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0045HA | BLUE CROSS BLUE SHIELD (01) | TX |
1245557-05 | (05) | TX |
124555706 | (05) | TX |
2606443 | AETNA (01) | TX |
F52278 | (02) | TX |