Provider Demographics
NPI:1558338061
Name:PERKINS, WILLIAM D (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:PERKINS
Suffix:
Gender:M
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:PO BOX 847176
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7176
Mailing Address - Country:US
Mailing Address - Phone:903-237-1800
Mailing Address - Fax:903-237-1810
Practice Address - Street 1:802 MEDICAL CIRCLE
Practice Address - Street 2:SUITE 300
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5100
Practice Address - Country:US
Practice Address - Phone:903-315-2730
Practice Address - Fax:903-315-2717
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH37292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13002077OtherR R MEDICARE
TX120393705Medicaid
TX13002077OtherR R MEDICARE
TXC20410Medicare UPIN