Provider Demographics
NPI:1114991064
Name:PERKINS, COBY D (DC)
Entity Type:Individual
Prefix:
First Name:COBY
Middle Name:D
Last Name:PERKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 W 33RD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1203
Mailing Address - Country:US
Mailing Address - Phone:806-331-2225
Mailing Address - Fax:806-331-2260
Practice Address - Street 1:4104 W 33RD AVE
Practice Address - Street 2:STE 200
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1203
Practice Address - Country:US
Practice Address - Phone:806-331-2225
Practice Address - Fax:806-331-2260
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC7044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64784Medicare UPIN
TX8F1415Medicare ID - Type Unspecified