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General NPI Number Information
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NPI Number | 1417180340
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Entity Type | Organization
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Legal Business Name | JAMES E. B. BERRY, M.D.,P.A.
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 1117 GALLAGHER DRIVE STE. 450
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City | SHERMAN
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State | TX
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Zip | 75090
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Country | US
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Telephone | 903-892-5568
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Fax | 903-892-1751
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Provider Business Mailing Address
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Address Line | 1117 GALLAGHER DRIVE STE. 450
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City | SHERMAN
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State | TX
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Zip | 75090
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Country | US
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Telephone | 903-892-5568
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Fax | 903-892-1751
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES BERRY
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Credential | M.D.
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Telephone | 903-892-5568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0050
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License Number State | TX
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