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NPI Code Detail

MEDICARE: TAMIKA L PERRY, D.O., P.A.

MEDICARE: TAMIKA L PERRY, D.O., P.A.
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
1174400000XSpecialistL9847TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111568317OTHERTXCAQH

General Provider Information

NPI Number : 1730115288
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAMIKA L PERRY, D.O., P.A.
Provider Business Mailing Address
First Line : 1251A E RED BIRD LN
Second Line :
City : DALLAS
State : TX
Zip : 75241-2008
Country : US
Telephone Number : 214-374-0827
Fax Number : 214-374-0927
Provider Business Practice Location Address
First Line : 1251A E RED BIRD LN
Second Line :
City : DALLAS
State : TX
Zip : 75241-2008
Country : US
Telephone Number : 214-374-0827
Fax Number : 214-374-0927
Authorized Official
Title or Position : PRESIDENT
Name : TAMIKA PERRY
Credential : D.O.
Telephone Number : 214-374-0827
Provider Enumeration Date : 06/25/2006
Last Update Date : 12/03/2007

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