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NPI Code Detail

MEDICARE: DR. MARCY L BERRY M.D.

MEDICARE: DR. MARCY L BERRY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianK8005TX

General Provider Information

NPI Number : 1114964426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCY L BERRY M.D.
Provider Business Mailing Address
First Line : 6907 MEADOWCREEK DR
Second Line :
City : DALLAS
State : TX
Zip : 75254-2710
Country : US
Telephone Number : 214-738-8608
Fax Number : 972-208-3186
Provider Business Practice Location Address
First Line : 6907 MEADOWCREEK DR
Second Line :
City : DALLAS
State : TX
Zip : 75254-2710
Country : US
Telephone Number : 214-738-8608
Fax Number : 972-208-3186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 02/06/2026

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