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General NPI Number Information
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NPI Number | 1316971740
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Entity Type | Individual
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Provider Name | ROBERT EUGENE BERRY DO
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 19200 PRESTON RD STE 120
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City | DALLAS
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State | TX
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Zip | 75252-2450
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Country | US
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Telephone | 469-200-2832
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Fax | 469-269-1074
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Provider Business Mailing Address
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Address Line | 19200 PRESTON RD STE 120
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City | DALLAS
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State | TX
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Zip | 75252-2450
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Country | US
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Telephone | 469-200-2832
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Fax | 469-269-1074
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 20A7616
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | M1511
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License Number State | TX
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