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General NPI Number Information
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NPI Number | 1043443054
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Entity Type | Organization
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Legal Business Name | DAVEY M PERRIN M.D.
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 206 S CLAY ST STE A
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City | ENNIS
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State | TX
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Zip | 75119-4530
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Country | US
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Telephone | 903-229-4292
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Fax | 903-229-4288
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Provider Business Mailing Address
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Address Line | 206 S CLAY ST STE A
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City | ENNIS
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State | TX
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Zip | 75119-4530
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Country | US
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Telephone | 903-229-4292
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Fax | 903-229-4288
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Authorized Official
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Title or Position | OWNER
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Name | DAVEY MELISSA PERRIN
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Credential | M.D.
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Telephone | 903-229-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | PHYTEMP
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License Number State | TX
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