Provider Demographics
NPI:1235579715
Name:PERUMAL, ARUNA (MD)
Entity Type:Individual
Prefix:
First Name:ARUNA
Middle Name:
Last Name:PERUMAL
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 1:19701 KINGWOOD DRIVE, BLDG 3
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3773
Mailing Address - Country:US
Mailing Address - Phone:281-358-5701
Mailing Address - Fax:281-358-7061
Practice Address - Street 1:19701 KINGWOOD DRIVE, BLDG 3
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-358-5701
Practice Address - Fax:281-358-7061
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP75362084P0804X
NY2664132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080462703Medicaid