Provider Demographics
NPI:1386937431
Name:PERRY, BENJAMIN FRANKLIN II (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:FRANKLIN
Last Name:PERRY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 848476
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-8476
Mailing Address - Country:US
Mailing Address - Phone:254-202-2600
Mailing Address - Fax:254-202-6510
Practice Address - Street 1:2201 MACARTHUR DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3161
Practice Address - Country:US
Practice Address - Phone:254-202-6500
Practice Address - Fax:254-202-6510
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-9150207Q00000X
TXQ4492207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine