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NPI Code Detail

MEDICARE: LLOYD STUART BERG PHD

MEDICARE:   LLOYD STUART BERG  PHD
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
1103T00000XPsychologist25608TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
188061AOTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548295785
Entity Type Code : Individual
Provider Name (Legal Business Name) : LLOYD STUART BERG PHD
Provider Business Mailing Address
First Line : 1601 RIO GRANDE ST STE 340
Second Line :
City : AUSTIN
State : TX
Zip : 78701-1162
Country : US
Telephone Number : 512-795-5500
Fax Number : 512-795-3502
Provider Business Practice Location Address
First Line : 3501 MILLS AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78731-6309
Country : US
Telephone Number : 512-324-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 12/14/2012

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Directions to “ LLOYD STUART BERG PHD” Practice Location

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