MEDICARE: ANGELIS BERIOS 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	H1040	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00QJ87	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689665382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIS BERIOS MD

Provider Business Mailing Address
First Line	:	24540 FM 1314 RD
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-4204
Country	:	US
Telephone Number	:	281-354-4009
Fax Number	:	281-354-8815

Provider Business Practice Location Address
First Line	:	24540 FM 1314 RD
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-4204
Country	:	US
Telephone Number	:	281-354-4009
Fax Number	:	281-354-8815

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/16/2008

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Directions to “ ANGELIS BERIOS MD” Practice Location

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