MEDICARE: DR. BERENICE CASTANEDA SERPAS MD

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	207Q00000X	Family Medicine Physician	28278	PR

General Provider Information

NPI Number	:	1154676302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERENICE CASTANEDA SERPAS MD

Provider Business Mailing Address
First Line	:	222 ARKADELPHIA RD NE
Second Line	:
City	:	HANCEVILLE
State	:	AL
Zip	:	35077-4700
Country	:	US
Telephone Number	:	256-352-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	4706 TIDEWATER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4138
Country	:	US
Telephone Number	:	713-498-7291
Fax Number	:

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

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	09/13/2016

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