Provider Demographics
NPI:1710197413
Name:PERO, COLIN DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:DANIEL
Last Name:PERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11970 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3768
Mailing Address - Country:US
Mailing Address - Phone:214-382-5100
Mailing Address - Fax:214-382-5199
Practice Address - Street 1:11970 N CENTRAL EXPY
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3768
Practice Address - Country:US
Practice Address - Phone:214-382-5100
Practice Address - Fax:214-382-5199
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA026489207Y00000X
TXN2729174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L17983Medicare PIN
TX482071YYQBMedicare PIN