Provider Demographics
NPI:1700832284
Name:BAMBERGER-PERKINS, ANNETTE H (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:H
Last Name:BAMBERGER-PERKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANNETTE
Other - Middle Name:H
Other - Last Name:BAMBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:517 N CARRIER PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5464
Mailing Address - Country:US
Mailing Address - Phone:469-251-1734
Mailing Address - Fax:972-642-5183
Practice Address - Street 1:517 N CARRIER PKWY STE A
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5464
Practice Address - Country:US
Practice Address - Phone:469-251-1734
Practice Address - Fax:972-642-5183
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3427207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200187440AMedicaid
TXJ3427Medicare UPIN
TX00N23YMedicare ID - Type Unspecified