Individual provider Active NPI

Roxanne E. Pero, MD

  • Student in an Organized Health Care Education/Training Program
  • Dallas, TX
National Provider Identifier
1508069790
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8160 Walnut Hill LN
Suite 200
Dallas, TX 75231-4339
Phone
(214) 363-4421
Fax
(214) 987-1657
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Obstetrics & Gynecology Physician 207V00000X N5332 TX

Addresses

Primary practice location

8160 Walnut Hill LN
Suite 200
Dallas, TX 75231-4339

Mailing address

8160 Walnut Hill LN
Suite 200
Dallas, TX 75231-4339
Phone (214) 363-4421

Other identifiers 2

IdentifierTypeStateIssuer
N5332OtherTXTEXAS MEDICAL BOARD
BP1-0026451OtherINSTITUTIONAL PERMIT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216000720 TX Practitioner - Obstetrics/Gynecology 0345438420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N5332TXMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1508069790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8160 WALNUT HILL LN",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314339",
            "telephone_number": "214-363-4421",
            "fax_number": "214-987-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 WALNUT HILL LN",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314339",
            "telephone_number": "214-363-4421",
            "fax_number": "214-987-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERO",
        "first_name": "ROXANNE",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N5332",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "N5332",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026451",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.