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General NPI Number Information
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NPI Number | 1386121093
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER BERLIOZ DO PA
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 10710 MCPHERSON RD SUITE 100
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City | LAREDO
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State | TX
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Zip | 78045-6363
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Country | US
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Telephone | 956-724-4822
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Fax |
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Provider Business Mailing Address
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Address Line | 810 FENWICK DR
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City | LAREDO
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State | TX
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Zip | 78041-2877
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Country | US
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Telephone | 956-763-6335
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY KAFATI
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Credential |
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Telephone | 956-763-6335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R6975
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License Number State | TX
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