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General NPI Number Information
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NPI Number | 1417191545
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Entity Type | Organization
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Legal Business Name | MARCY L. BERRY, MD, PA
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 2100 HEDGCOXE RD SUITE 190
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City | PLANO
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State | TX
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Zip | 75025-3156
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Country | US
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Telephone | 972-208-8668
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Fax | 972-208-3186
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Provider Business Mailing Address
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Address Line | 2100 HEDGCOXE RD SUITE 190
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City | PLANO
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State | TX
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Zip | 75025-3156
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Country | US
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Telephone | 972-208-8668
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Fax | 972-208-3186
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. MARCY L BERRY
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Credential | M.D.
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Telephone | 972-208-8668
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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 | K8005
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License Number State | TX
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