Basic Information
| Provider Information | |||||||||
| NPI: | 1093735375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | SEBRINA | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64568 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850824568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106140180 | ||||||||
| FaxNumber: | 2106140710 | ||||||||
| Practice Location | |||||||||
| Address1: | 4204 GARDENDALE ST | ||||||||
| Address2: | STE 312 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106140180 | ||||||||
| FaxNumber: | 2106140710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 01/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0204X | K8417 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 089986603 | 05 | TX | MEDICAID | 8G2437 | 01 | TX | BCBS | OTHER | 089986604 | 05 | TX | MEDICAID |