Provider Demographics
NPI:1285971127
Name:PERKINS, MICHAEL JOHN (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:PERKINS
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:1451 GREENS PRAIRIE ROAD WEST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8734
Mailing Address - Country:US
Mailing Address - Phone:979-690-2478
Mailing Address - Fax:979-690-2402
Practice Address - Street 1:1451 GREENS PRAIRIE ROAD WEST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8734
Practice Address - Country:US
Practice Address - Phone:979-690-2478
Practice Address - Fax:979-690-2402
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2022-09-16
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Provider Licenses
StateLicense IDTaxonomies
TX11318372081S0010X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX294689ZG1MMedicare PIN