Provider Demographics
NPI:1336456326
Name:PERRYMAN, JAMES CHARLES JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHARLES
Last Name:PERRYMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHUCK
Other - Middle Name:
Other - Last Name:PERRYMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18725 DALLAS PKWY
Mailing Address - Street 2:#2815
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-4239
Mailing Address - Country:US
Mailing Address - Phone:972-400-1567
Mailing Address - Fax:
Practice Address - Street 1:18725 DALLAS PKWY
Practice Address - Street 2:#2815
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-4239
Practice Address - Country:US
Practice Address - Phone:972-400-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-11
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional