Provider Demographics
NPI:1932202223
Name:PERKINS, TERRY DON
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:DON
Last Name:PERKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 GREENBRANCH LOOP
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77808
Mailing Address - Country:US
Mailing Address - Phone:979-776-9040
Mailing Address - Fax:
Practice Address - Street 1:3811 SAGEBRIAR DRIVE
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-6107
Practice Address - Country:US
Practice Address - Phone:979-774-0498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8711207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102636103Medicaid
TX8R9481OtherBCBS ID #
TXG34600Medicare UPIN