| NPI Details | |
|---|---|
| NPI | 1194125161 |
| Enumeration Date | 08/27/2014 |
| Last Updated | 03/05/2015 |
| Entity Type | Healthcare Provider |
| Active | Over 2 years ago |
| Authorized Information | |
|---|---|
| Name | RUSSELL K. RUSSELL |
| Position | OWNER |
| Phone | (409) 892-7090 |
| Fax | (409) 892-4324 |
| Practice Location | |
|---|---|
| 2965 HARRISON ST SUITE 315 BEAUMONT TX, 77702-1100, US |
|
| Phone | (409) 892-7090 |
| Fax | (409) 892-4324 |
| Business Location | |
|---|---|
| 2965 HARRISON ST SUITE 315 BEAUMONT TX, 77702-1100, US |
|
| Phone | (409) 892-7090 |
| Fax | (409) 892-4324 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207K00000X |
| License State | Texas |
| License Number | N3241 |
| Remove 1194125161 NPI Number | |
According to our database, Russell Perry, Md, Pa NPI is 1194125161, taxonomy code is 207K00000X and license number is N3241, license state is located at Texas. Russell Perry, Md, Pa physically located at 2965 Harrison St, Beaumont TX, 77702-1100. NPI Number 1033115704 has the healthcare provider type.
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1194125161 NPI number is provided on an as is basis without warranty of any kind. 1194125161 is maintained by the National Plan & Provider Enumeration System. The contents of Russell Perry, Md, Pa are for informational purposes only.
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