Basic Information
Provider Information
NPI: 1366452088
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERKINS
FirstName: HENRY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7703 FLOYD CURL DR
Address2: MC7977
City: SAN ANTONIO
State: TX
PostalCode: 782293901
CountryCode: US
TelephoneNumber: 2102571400
FaxNumber: 2102571428
Practice Location
Address1: 7703 FLOYD CURL DR
Address2: MC7977
City: SAN ANTONIO
State: TX
PostalCode: 782293901
CountryCode: US
TelephoneNumber: 2102571400
FaxNumber: 2102571428
Other Information
ProviderEnumerationDate: 08/08/2006
LastUpdateDate: 07/28/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XG6591TXY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
04740820105TX MEDICAID
11021193801TXMEDICARE RROTHER


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