Provider Demographics
NPI:1447017496
Name:BUTLER, PERIL DEQUAL JR
Entity type:Individual
Prefix:MR
First Name:PERIL
Middle Name:DEQUAL
Last Name:BUTLER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20910 AZELEA FIELD ST
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2288
Mailing Address - Country:US
Mailing Address - Phone:832-702-0618
Mailing Address - Fax:
Practice Address - Street 1:20910 AZELEA FIELD ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2288
Practice Address - Country:US
Practice Address - Phone:832-702-0618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility