MEDICARE: DORIS A. PERRY

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	251B00000X	Case Management Agency	23892	TX

General Provider Information

NPI Number	:	1437420379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DORIS A. PERRY

Provider Business Mailing Address
First Line	:	3923 BRADEN DR N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-6796
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3923 BRADEN DR N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-6796
Country	:	US
Telephone Number	:	832-865-6024
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. DORIS A PERRY
Credential	:
Telephone Number	:	832-865-6024

Provider Enumeration Date	:	01/24/2012
Last Update Date	:	01/24/2012

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