Provider Demographics
NPI:1417930090
Name:PERKS, JOSEPH MILLARD (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MILLARD
Last Name:PERKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 JOE RAMSEY BLVD E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401
Mailing Address - Country:US
Mailing Address - Phone:903-408-7700
Mailing Address - Fax:
Practice Address - Street 1:4211 JOE RAMSEY BOULEVARD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401
Practice Address - Country:US
Practice Address - Phone:903-408-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP086E8362Medicaid
TX8AP320OtherBLUE CROSS BLUE SHIELD OF TEXAS
TXP086E8362Medicaid
TX8AP320OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX8K3565Medicare PIN
TXE09843Medicare UPIN