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General NPI Number Information
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NPI Number | 1326649229
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Entity Type | Individual
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Provider Name | LAURA PERKINS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 1201 STONE ST
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City | KILGORE
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State | TX
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Zip | 75662-5433
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Country | US
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Telephone | 903-983-1056
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Fax | 903-983-1242
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Provider Business Mailing Address
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Address Line | 1303 LESLEY LN
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City | LONGVIEW
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State | TX
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Zip | 75604-2871
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Country | US
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Telephone | 903-918-5567
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 53942
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License Number State | TX
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