Provider Demographics
NPI:1275574808
Name:PERL, TRISH MARIE (MD)
Entity Type:Individual
Prefix:
First Name:TRISH
Middle Name:MARIE
Last Name:PERL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:MARIE
Other - Last Name:PERL-DELISLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-2800
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-645-2800
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45667207RI0200X
MDD50416207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD795711400Medicaid
MDKR70298SMedicare PIN
MDE15284Medicare UPIN