Healthcare Provider Details

I. General information

NPI: 1760643050
Provider Name (Legal Business Name): PERNIA LATIF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 WEST LOOP S STE 300
BELLAIRE TX
77401-2913
US

IV. Provider business mailing address

6300 WEST LOOP S STE 300
BELLAIRE TX
77401-2913
US

V. Phone/Fax

Practice location:
  • Phone: 713-568-3348
  • Fax: 713-357-5493
Mailing address:
  • Phone: 713-568-3348
  • Fax: 713-357-5493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberP8382
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: