MEDICARE: DR. DAN G PERKINS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2-0996	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86875A	OTHER	TX	BLUE CROSS BLUE SHIELD
2	P00207001	OTHER	TX	RAIL ROAD

General Provider Information

NPI Number	:	1023037405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAN G PERKINS PH.D.

Provider Business Mailing Address
First Line	:	523 W HUNT ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75069-3857
Country	:	US
Telephone Number	:	972-562-9140
Fax Number	:	800-819-1655

Provider Business Practice Location Address
First Line	:	8059 SCYENE CIR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75227-5534
Country	:	US
Telephone Number	:	800-257-8715
Fax Number	:	800-819-1655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/09/2007

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