MEDICARE: ELMER V BERNSTAM 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
1	207R00000X	Internal Medicine Physician	L6787	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8F8253	OTHER	TX	BCBS
3	150573702	OTHER	TX	CSHCN

General Provider Information

NPI Number	:	1154355196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELMER V BERNSTAM M.D.

Provider Business Mailing Address
First Line	:	7000 FANNIN ST STE 600
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-5400
Country	:	US
Telephone Number	:	713-500-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 FANNIN ST STE 600
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-5400
Country	:	US
Telephone Number	:	713-500-6700
Fax Number	:

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	01/28/2022

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