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General NPI Number Information
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NPI Number | 1013971134
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD BERKELEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 1302 WAUGH DR # 684
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City | HOUSTON
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State | TX
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Zip | 77019-3908
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Country | US
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Telephone | 970-230-0154
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Fax | 970-315-0374
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Provider Business Mailing Address
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Address Line | 1302 WAUGH DR # 684
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City | HOUSTON
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State | TX
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Zip | 77019-3908
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Country | US
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Telephone | 970-230-0154
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Fax | 970-315-0374
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | F3042
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DRP 0000604
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License Number State | CO
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