Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 1131837 | TX |
N | 213ES0000X | Sports Medicine | 1131837 | TX |
Y | 225100000X | Physical Therapist | 1131837 | TX |
NPI | 1285971127 |
---|---|
Provider Name | Michael John Perkins |
First Address | College Station, TX 77845-8734 |
Second Address | College Station, TX 77845-8734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2013 |
Last Update Date | 08/05/2018 |