Healthcare Provider Details

I. General information

NPI: 1952621559
Provider Name (Legal Business Name): DAVID MARTIN BERGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6621 FANNIN ST
HOUSTON TX
77030-2358
US

IV. Provider business mailing address

10754 HAWTHORN TRL
WOODBURY MN
55129-8767
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-6422
  • Fax: 832-825-0164
Mailing address:
  • Phone: 956-867-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberR8533
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: