Individual
DR. CAROL ANN PERUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13601 PRESTON RD, SUITE 1000W, DALLAS, TX 75240-4911
(972) 715-5000
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E8814
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050064750
RR MEDICARE
TX
05
—
123618401
—
TX
05
—
123618406
—
TX
05
—
123618407
—
TX
05
—
166154801
—
TX
01
—
84702K
BCBS
TX
Enumeration date
12/22/2005
Last updated
12/07/2012
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