Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | K8417 | TX |
NPI | 1093735375 |
---|---|
Provider Name | Dr. Sebrina D Perkins |
First Address | Phoenix, AZ 85082-4568 |
Second Address | San Antonio, TX 78229-3132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 26/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
089986603 | (05) | TX |
089986604 | (05) | TX |
8G2437 | BCBS (01) | TX |