MEDICARE: PERFORMANCE AND WELLNESS PLLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1487535704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFORMANCE AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	3839 HARRY WURZBACH RD BLDG 8
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3176
Country	:	US
Telephone Number	:	504-256-1671
Fax Number	:

Provider Business Practice Location Address
First Line	:	3839 HARRY WURZBACH RD BLDG 8
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-3176
Country	:	US
Telephone Number	:	504-256-1671
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GARY BERNARD
Credential	:	MD
Telephone Number	:	504-256-1671

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	09/11/2025

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