NPIMap

Individual provider Active NPI

Christopher A Perro, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Tyler, TX
National Provider Identifier
1346462496
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
Q7259 Issued in TX
Practice address
2210 Three Lakes Pkwy Ste 100
Tyler, TX 75703-0642
Phone
(903) 747-4050
Fax
(903) 747-4075
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A117254 CA
Otolaryngology Physician 207Y00000X 125-051674 IL
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X Q7259 TX Primary

Addresses

Primary practice location

2210 Three Lakes Pkwy Ste 100
Tyler, TX 75703-0642

Mailing address

PO Box 591819
San Antonio, TX 78259-0140
Phone (830) 328-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160504000294 TX Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9537338322 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Southern Illinois University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

2210 Three Lakes Pkwy
Suite 100
Tyler, TX 75703-0642
Phone (903) 747-4050

701 Olympic Plaza Cir
Tyler, TX 75701-1950
Phone (903) 531-8109

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A117254CAMDOtolaryngology Physician
125-051674ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Aesthetics of Texas, PLLC CurrentSince Jul 1, 2016 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2019 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Oct 1, 2019 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Oct 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Sep 1, 2019 Accepting new patients
Midwest Emergency Department Specialists LTD Past Accepting new patients
Manuel a. Lopez, MD, Inc PastSince Jul 1, 2016 Accepting new patients

Locations

109 Falls Ct
Ste 100
Boerne, TX 78006
Phone (210) 495-5771

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

66 Gruene Park Dr
Ste 210
New Braunfels, TX 78130
Phone (830) 730-4375

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

18322 Sonterra Pl
Ste 107
San Antonio, TX 78258
Phone (210) 495-5771

2210 Three Lakes Pkwy
Ste 100
Tyler, TX 75703
Phone (903) 747-4050

Interoperability endpoints

  • Direct secure messaging: cperro355603@ahs.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1346462496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591819",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782590140",
            "telephone_number": "830-328-4206",
            "fax_number": "210-966-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 THREE LAKES PKWY STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030642",
            "telephone_number": "903-747-4050",
            "fax_number": "903-747-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRO",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A117254",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125-051674",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "Q7259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.