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NPI Code Detail

MEDICARE: BARRY D. BERGER PH.D.

MEDICARE: BARRY D. BERGER PH.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
1103TC0700XClinical Psychologist2-4485TX

General Provider Information

NPI Number : 1780677575
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRY D. BERGER PH.D.
Provider Business Mailing Address
First Line : 2504 N CONWAY AVE
Second Line :
City : MISSION
State : TX
Zip : 78574-2349
Country : US
Telephone Number : 956-519-9000
Fax Number : 956-519-7722
Provider Business Practice Location Address
First Line : 2504 N CONWAY AVE
Second Line :
City : MISSION
State : TX
Zip : 78574-2349
Country : US
Telephone Number : 956-519-9000
Fax Number : 956-519-7722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 07/09/2007

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Directions to “ BARRY D. BERGER PH.D.” Practice Location

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