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NPI 1144792094

NPI 1144792094 : OTIS LEE PERKINS II DC : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1144792094
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    Entity Type          |    Individual 
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    Provider Name        |    OTIS LEE PERKINS II DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/17/2018
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    Last Update Date     |    12/08/2025
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Provider Practice Location Address
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    Address Line         |    8499 GREENVILLE AVE STE 203 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75231-2421
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    Country              |    US
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    Telephone            |    469-620-6245
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    Fax                  |    214-468-4779
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Provider Business Mailing Address
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    Address Line         |    8499 GREENVILLE AVE STE 203 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75231-2421
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    Country              |    US
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    Telephone            |    469-620-6245
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    Fax                  |    214-468-4779
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    5961
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    License Number State |    OR
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