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General NPI Number Information
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NPI Number | 1578599205
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Entity Type | Individual
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Provider Name | JOSE L BERLIOZ MD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 10710 MCPHERSON RD STE 101
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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 | 956-724-7145
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Fax | 956-724-4944
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Provider Business Mailing Address
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Address Line | P O BOX 450594
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City | LAREDO
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State | TX
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Zip | 78045-0014
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Country | US
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Telephone | 956-724-7145
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Fax | 956-724-4944
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K5812
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | K5812
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | K5812
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License Number State | TX
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