Physician Compare National (NPI:1083639462)

HEALTHCARE PROVIDER: DENIS EUGENE BERGERON JR. M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1083639462
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123212636
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101028001135
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BERGERON
	Individual professional last name
Provider First Name	DENIS
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3325 PLAINVIEW ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	PASADENA
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	775041923
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7139478837
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	670031
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST LUKE'S PATIENTS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y