=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063670115
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANNY PERKINS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2008
-----------------------------------------------------
Last Update Date | 02/08/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5353 WILLIAMS DR SUITE 108
-----------------------------------------------------
City | GEORGETOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78633-2044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-948-7604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5353 WILLIAMS DR SUITE 108
-----------------------------------------------------
City | GEORGETOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78633-2044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-948-7604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | 50479
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------