Provider Demographics
NPI:1760643050
Name:LATIF, PERNIA (MD)
Entity type:Individual
Prefix:
First Name:PERNIA
Middle Name:
Last Name:LATIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 WEST LOOP S STE 300
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2913
Mailing Address - Country:US
Mailing Address - Phone:713-568-3348
Mailing Address - Fax:713-357-5493
Practice Address - Street 1:6300 WEST LOOP S STE 300
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2913
Practice Address - Country:US
Practice Address - Phone:713-568-3348
Practice Address - Fax:713-357-5493
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8382207R00000X
MN54484207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN54484OtherMINNESOTA STATE LICENCE NUMBER