Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 17445 | TX |
NPI | 1518980275 |
---|---|
Provider Name | Dr. Steven Jay Perkins |
First Address | Austin, TX 78746 |
Second Address | Austin, TX 78746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/07/2007 |