Provider Demographics
NPI:1124994330
Name:PERRY, BERTHA FAYE I
Entity type:Individual
Prefix:MRS
First Name:BERTHA
Middle Name:FAYE
Last Name:PERRY
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 PARK CENTRAL APT 1411
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-7952
Mailing Address - Country:US
Mailing Address - Phone:601-573-7753
Mailing Address - Fax:601-573-7753
Practice Address - Street 1:1701 PARK CENTRAL APT 1411
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-7952
Practice Address - Country:US
Practice Address - Phone:601-573-7753
Practice Address - Fax:601-573-7753
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant