Provider Demographics
NPI:1033100375
Name:PERI, USHA N (MD)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:N
Last Name:PERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 COLORADO BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6884
Mailing Address - Country:US
Mailing Address - Phone:940-320-1708
Mailing Address - Fax:940-565-5457
Practice Address - Street 1:1600 WATERS RIDGE
Practice Address - Street 2:STE A
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057
Practice Address - Country:US
Practice Address - Phone:972-219-0558
Practice Address - Fax:972-436-9273
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4527207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
390008039OtherRR MEDICARE
TX4004203Medicaid
390008039OtherRR MEDICARE