MEDICARE: DR. KENNETH GREGORY BERLINER 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
1	207X00000X	Orthopaedic Surgery Physician	K3682	TX

General Provider Information

NPI Number	:	1881683803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH GREGORY BERLINER M.D.

Provider Business Mailing Address
First Line	:	4710 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2204
Country	:	US
Telephone Number	:	713-936-5735
Fax Number	:	281-875-3285

Provider Business Practice Location Address
First Line	:	4710 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-2204
Country	:	US
Telephone Number	:	713-936-5735
Fax Number	:	281-875-0316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	01/03/2014

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