MEDICARE: DR. MICHAEL LOUIS BERGERON PHARM. 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
1	1835P1200X	Pharmacotherapy Pharmacist	34731	TX

General Provider Information

NPI Number	:	1154323954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LOUIS BERGERON PHARM. D.

Provider Business Mailing Address
First Line	:	36065 SANTA FE AVE
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5060
Country	:	US
Telephone Number	:	254-553-6505
Fax Number	:

Provider Business Practice Location Address
First Line	:	36000 DARNALL LOOP
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5095
Country	:	US
Telephone Number	:	254-288-4128
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/29/2025

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