Provider Demographics
NPI:1285980953
Name:WEST PLANO DIABETES AND ENDOCRINE CENTER, P.A.
Entity type:Organization
Organization Name:WEST PLANO DIABETES AND ENDOCRINE CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:H
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-639-8799
Mailing Address - Street 1:6124 W PARKER RD
Mailing Address - Street 2:SUITE 332
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8122
Mailing Address - Country:US
Mailing Address - Phone:972-981-7812
Mailing Address - Fax:972-981-7836
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:SUITE 332
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:972-981-7812
Practice Address - Fax:972-981-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6228207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080422101Medicaid
TX080422101Medicaid
C09792Medicare UPIN