Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 1047412 | TX |
NPI | 1023681608 |
---|---|
Provider Name | Perry C Bishop |
First Address | Dripping Springs, TX 78620-2007 |
Second Address | Leander, TX 78641-3578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2021 |
Last Update Date | 21/07/2021 |