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NPI Code Detail

MEDICARE: DR. MARY CATHERINE BERGMAN M.D.

MEDICARE: DR. MARY CATHERINE BERGMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianH7270TX
2208M00000XHospitalist PhysicianH7270TN

General Provider Information

NPI Number : 1134187982
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY CATHERINE BERGMAN M.D.
Provider Business Mailing Address
First Line : 3111 QUENBY AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77005-2337
Country : US
Telephone Number : 713-349-8565
Fax Number :
Provider Business Practice Location Address
First Line : 3500 GASTON AVE
Second Line : BAYLOR UNIV MEDICAL CENTER 5TH FLOOR TRUETT
City : DALLAS
State : TX
Zip : 75246-2096
Country : US
Telephone Number : 214-820-4012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 02/22/2016

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