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General NPI Number Information
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NPI Number | 1114921020
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Entity Type | Individual
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Provider Name | MICHAEL BERTINO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 21 SPURS LN STE 310
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1679
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Country | US
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Telephone | 210-615-8332
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Fax |
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Provider Business Mailing Address
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Address Line | 10740 N GESSNER RD STE 310
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City | HOUSTON
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State | TX
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Zip | 77064-1240
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Country | US
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Telephone | 281-897-0416
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Fax | 800-346-9037
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D4928
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License Number State | TX
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