MEDICARE: DAVID PERRAULT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0122X	Plastic and Reconstructive Surgery Physician	W6347	TX

General Provider Information

NPI Number	:	1396241659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID PERRAULT MD

Provider Business Mailing Address
First Line	:	6410 FANNIN ST STE 1400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-5389
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST STE 1400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-5389
Country	:	US
Telephone Number	:	650-723-6596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2018
Last Update Date	:	06/06/2026

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Directions to “ DAVID PERRAULT MD” Practice Location

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