Provider Demographics
NPI:1083959357
Name:PERRY, NOA
Entity Type:Individual
Prefix:
First Name:NOA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOA
Other - Middle Name:
Other - Last Name:PELEG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 UPVALLEY RUN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3667
Mailing Address - Country:US
Mailing Address - Phone:617-758-9608
Mailing Address - Fax:
Practice Address - Street 1:5800 UPVALLEY RUN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3667
Practice Address - Country:US
Practice Address - Phone:617-758-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ225100000X
MA1356333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist