MEDICARE: CHRISTOPHER E. BERRY 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	23939	OK
2	207Q00000X	Family Medicine Physician	M9857	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8AL611	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275503641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER E. BERRY MD

Provider Business Mailing Address
First Line	:	5501 LBJ FWY
Second Line	:	STE 950
City	:	DALLAS
State	:	TX
Zip	:	75240-2362
Country	:	US
Telephone Number	:	972-945-4600
Fax Number	:	855-885-7652

Provider Business Practice Location Address
First Line	:	8390 LBJ FWY
Second Line	:	STE 1000B
City	:	DALLAS
State	:	TX
Zip	:	75243-1188
Country	:	US
Telephone Number	:	972-945-4600
Fax Number	:	855-885-7652

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	03/03/2020

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