| |
3900 Commerce Street Suite 106, Dallas, TX 75226-7700 | |
(214) 997-3481 | |
(214) 347-9136 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 3900 Commerce Street Suite 106, Dallas, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578255386 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Eddwado Perkin |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1649513383 PECOS PAC ID: 4981061983 Enrollment ID: I20230607000687 |
Mailing Address | Practice Location Address |
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3900 Commerce Street Suite 106, Dallas, TX 75226-7700 Ph: (214) 997-3481 | 3900 Commerce Street Suite 106, Dallas, TX 75226-7700 Ph: (214) 997-3481 |