Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | J4430 | TX |
N | 207PP0204X | Pediatric Emergency Physician | J4430 | TX |
NPI | 1467558510 |
---|---|
Provider Name | Dr. Steven Kyle Perilman |
First Address | Lafayette, LA 70508-3870 |
Second Address | Corpus Christi, TX 78411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00L42V | BCBSTX GRP PIN (01) | TX |
10022295 | AMERIGROUP PIN (01) | TX |
108867 | SUPERIOR PIN (01) | TX |
121320100 | FIRSTCARE PIN (01) | TX |
134992007 | (05) | TX |
134992008 | (05) | TX |
137283103 | (05) | TX |
137345805 | (05) | TX |
1415257 | UHC PIN (01) | TX |
1669442042 | GRP NPI NUMBER (01) | |
1854186 | FIRSTHEALTH PIN (01) | TX |
4731603 | CIGNA PIN (01) | TX |
5040636 | AETNA PIN (01) | TX |
88629X | BCBSTX IND PIN (01) | TX |
G15191 | (02) |