Individual
DR. JACQUELYN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
3020 RACE ST, FORT WORTH, TX 76111-4116
(817) 838-9424
(817) 838-9425
Mailing address
3020 RACE ST, FORT WORTH, TX 76111-4116
(817) 838-9424
(817) 838-9425
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
1244
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00L64N
BLUE CROSS BLUE SHEILD
TX
05
—
018771801
—
TX
01
—
2097757
AETNA HMO
TX
01
—
4407693
AETNA PPO
TX
01
—
621526786
PHCS
TX
Enumeration date
03/23/2006
Last updated
10/07/2009
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