Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | E7227 | TX |
NPI | 1174668479 |
---|---|
Provider Name | William M Perryman |
First Address | Fort Worth, TX 76115-0426 |
Second Address | Burleson, TX 76028-7012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 28/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C20433 | (02) | TX |