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General NPI Number Information
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NPI Number | 1669725735
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Entity Type | Organization
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Legal Business Name | MARGARET M PERISH
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 3600 GUS THOMASSON RD SUITE 146
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City | MESQUITE
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State | TX
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Zip | 75150-6200
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Country | US
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Telephone | 972-832-1192
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Fax | 972-698-8934
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Provider Business Mailing Address
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Address Line | 211 ROCKBROOK DR
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City | ROCKWALL
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State | TX
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Zip | 75087-4211
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Country | US
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Telephone | 972-832-1192
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Fax | 972-698-8934
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MARGARET M PERISH
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Credential | PSYD
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Telephone | 972-832-1192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 36230
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License Number State | TX
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