Perry, Jacquelyn

Perry, Jacquelyn is an individual health care provider with primary practice located at 3020 Race St , Fort Worth TX 76111-4116. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as her primary health care specialty. Perry, Jacquelyn can be contacted via phone (817) 838-9424.

Contact Information

Primary practice address
3020 Race St Fort Worth TX 76111-4116
Phone: (817) 838-9424
Fax: (817) 838-9425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 1244 Texas

Profile Details

NPI number 1346200649
LBN Legal business name Perry, Jacquelyn
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Oct 7th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346200649 NPPES
Texas Other 4407693 AETNA PPO
Texas Other 621526786 AETNA PPO
Texas Other 621526786 AETNA PPO
Texas Other 621526786 AETNA PPO
Texas Other 00L64N AETNA PPO
Texas MEDICAID 018771801 AETNA PPO
Texas Other 2097757 AETNA PPO

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