Healthcare Provider Details

I. General information

NPI: 1477465748
Provider Name (Legal Business Name): DIDAR BENGISU BERBEROGLU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23541 WESTHEIMER PKWY STE 160
KATY TX
77494-3598
US

IV. Provider business mailing address

23541 WESTHEIMER PKWY STE 160
KATY TX
77494-3598
US

V. Phone/Fax

Practice location:
  • Phone: 832-585-8675
  • Fax:
Mailing address:
  • Phone: 832-585-8675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number25-416779
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: