Active NPI
Maya Christianne Peris, MD
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1720152572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- J6206
- Practice address
- 5477 Glen Lakes Dr
Suite 210
Dallas, TX 75231-4375 - Phone
- (214) 691-4988
- Fax
- (214) 373-6444
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | J6206 | TX | Primary |
Addresses
Primary practice location
5477 Glen Lakes Dr
Suite 210
Dallas, TX 75231-4375
Mailing address
5477 Glen Lakes Dr
Suite 210
Dallas, TX 75231-4375
Phone (214) 691-4988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J6206 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720152572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5477 GLEN LAKES DR",
"address_2": "SUITE 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314375",
"telephone_number": "214-691-4988",
"fax_number": "214-373-6444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5477 GLEN LAKES DR",
"address_2": "SUITE 210",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314375",
"telephone_number": "214-691-4988",
"fax_number": "214-373-6444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERIS",
"first_name": "MAYA",
"middle_name": "CHRISTIANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "J6206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
- Perioperative and Internal Medicine Group PLLC
- Perioperative and Internal Medicine Group PLLC
- Perioperative and Transitional Medicine Group PLLC
- Perioperative and Transitional Medicine Group PLLC
- Luke Prakash Peris, M.D.
- Margaret M Perish, PSY.D.
- Peritus Medical Group, LLC
- Ashley Deann Perkins-Tinsley, MSN, RN
- Allie Mishael Perkins
- Ashlen Blake Perkins, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.