Individual
INDEEVAR PERAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 AIRPORT RD, SULPHUR SPRINGS, TX 75482-2105
(903) 885-7671
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301098250
MI
208M00000X
Hospitalist Physician
Primary
S6013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415523601
—
TX
Enumeration date
07/20/2011
Last updated
01/20/2021
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