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General NPI Number Information
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NPI Number | 1821642000
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Entity Type | Organization
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Legal Business Name | BERAKAH US SERVICES, LLC
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Dates
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Enumeration Date | 07/26/2019
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 3227 THICKET PATH WAY
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City | KATY
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State | TX
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Zip | 77493-4451
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Country | US
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Telephone | 516-506-5652
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Fax |
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Provider Business Mailing Address
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Address Line | 3227 THICKET PATH WAY
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City | KATY
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State | TX
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Zip | 77493-4451
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Country | US
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Telephone | 516-506-5652
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CESAR AMAYA ROMERO
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Credential |
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Telephone | 516-506-5652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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