MEDICARE: ATHENA PERRY-LE

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	156F00000X	Technician/Technologist

General Provider Information

NPI Number	:	1649132382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATHENA PERRY-LE

Provider Business Mailing Address
First Line	:	2612 WOOD CRK
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-1593
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2612 WOOD CRK
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75181-1593
Country	:	US
Telephone Number	:	469-456-3431
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ ATHENA PERRY-LE ” Practice Location

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