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General NPI Number Information
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NPI Number | 1174885925
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Entity Type | Organization
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Legal Business Name | PERRI DERMATOLOGY, PLLC INC
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 4015 INTERSTATE 45 N STE 200
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City | CONROE
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State | TX
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Zip | 77304-5076
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Country | US
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Telephone | 936-522-4966
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Fax | 936-522-4998
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Provider Business Mailing Address
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Address Line | 4015 INTERSTATE 45 N STE 200
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City | CONROE
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State | TX
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Zip | 77304-5076
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Country | US
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Telephone | 936-522-4966
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY JOSEPH PERRI III
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Credential | M.D.
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Telephone | 936-522-4966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | M6826
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License Number State | TX
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