MEDICARE: MR. LLOYD ARTHUR BERGMAN II L.P.C.

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	101YM0800X	Mental Health Counselor	3536	OK
2	101YM0800X	Mental Health Counselor	1417	TX

General Provider Information

NPI Number	:	1255423653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LLOYD ARTHUR BERGMAN II L.P.C.

Provider Business Mailing Address
First Line	:	9670 DRIPPING SPRINGS RD
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75021-4382
Country	:	US
Telephone Number	:	903-463-1193
Fax Number	:

Provider Business Practice Location Address
First Line	:	9670 DRIPPING SPRINGS RD
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75021-4382
Country	:	US
Telephone Number	:	903-463-1193
Fax Number	:

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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