Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | K4527 | TX |
NPI | 1033100375 |
---|---|
Provider Name | Usha N Peri |
First Address | Denton, TX 76210-6884 |
Second Address | Lewisville, TX 75057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 17/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390008039 | RR MEDICARE (01) | |
4004203 | (05) | TX |