Provider Demographics
NPI:1215109525
Name:PERKINS, MELDONNA RAMON (OTR)
Entity type:Individual
Prefix:
First Name:MELDONNA
Middle Name:RAMON
Last Name:PERKINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 WASHITA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2336
Mailing Address - Country:US
Mailing Address - Phone:210-267-5092
Mailing Address - Fax:
Practice Address - Street 1:7331 WASHITA WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2336
Practice Address - Country:US
Practice Address - Phone:210-267-5092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111679225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist