Provider Demographics
NPI:1770613994
Name:PERIS, LUKE PRAKASH (MD)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:PRAKASH
Last Name:PERIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14800 QUORUM DR
Mailing Address - Street 2:465
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7073
Mailing Address - Country:US
Mailing Address - Phone:972-661-2066
Mailing Address - Fax:972-661-0313
Practice Address - Street 1:14800 QUORUM DR
Practice Address - Street 2:465
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7073
Practice Address - Country:US
Practice Address - Phone:972-661-2066
Practice Address - Fax:972-661-0313
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ58642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry