Provider Demographics
NPI:1497700058
Name:PERKINSON, JOSEPH C III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:PERKINSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17198 ST LUKES WAY
Mailing Address - Street 2:SUITE 430
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8011
Mailing Address - Country:US
Mailing Address - Phone:936-202-3108
Mailing Address - Fax:936-202-3126
Practice Address - Street 1:17198 ST LUKES WAY
Practice Address - Street 2:SUITE 430
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8011
Practice Address - Country:US
Practice Address - Phone:936-202-3108
Practice Address - Fax:936-202-3126
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2015-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080178125OtherRR MEDICARE
TX0078GCOtherBC/BS OF TEXAS
TX0078GCOtherBC/BS OF TEXAS
TX080178125OtherRR MEDICARE
00242GMedicare PIN