Healthcare Provider Details

I. General information

NPI: 1740538925
Provider Name (Legal Business Name): SARAH ROZEMAN BERG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WATERVIEW PKWY
BOERNE TX
78006-2885
US

IV. Provider business mailing address

1355 CENTRAL PKWY S STE 400
SAN ANTONIO TX
78232-5057
US

V. Phone/Fax

Practice location:
  • Phone: 210-653-5501
  • Fax:
Mailing address:
  • Phone: 210-653-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberQ3332
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: