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Radie Floyd Perry

Physical Medicine & Rehabilitation

Allopathic & Osteopathic Physicians

8220 Walnut Hill Ln, Suite 508, Dallas, TX 75231-4427

PECOS Enrollment

This provider is enrolled in PECOS as RADIE PERRY.

Based on the most recent information from CMS, provider Radie Floyd Perry is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1710072269
Provider Type
Individual
Full Name
Perry, Radie Floyd
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
10/3/2006
Last Updated
5/13/2016

Contact Information

Practice Location

8220 Walnut Hill Ln, Suite 508, Dallas, TX 75231-4427

(214) 691-6029

(214) 373-6857

Mailing Location

8220 Walnut Hill Ln, Suite 508, Dallas, TX 75231-4427

(214) 691-6029

(214) 373-6857

Provider Taxonomies

Code	Description	License
Code 208100000X Primary	Description Physical Medicine & Rehabilitation Allopathic & Osteopathic Physicians	License G6753 Texas

Provider Identifiers

ID	Description	Issuer
ID 109408802	Description Medicaid	Issuer Unlisted Texas
ID 4140238	Description Other	Issuer AETNA Texas
ID 88T402	Description Other	Issuer BLUE CROSS Texas
ID 122503904	Description Medicaid	Issuer Unlisted Texas
ID 8559K0	Description Other	Issuer MEDICARE Texas
ID 2839522003	Description Other	Issuer CIGNA Texas

Radie Floyd Perry

PECOS Enrollment

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