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NPI Code Detail

MEDICARE: MS. KAILA BERGAIL WHERRY PA-C

MEDICARE: MS. KAILA BERGAIL WHERRY PA-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
1207Q00000XFamily Medicine PhysicianPA16731TX
2207V00000XObstetrics & Gynecology PhysicianPA16731TX
3363A00000XPhysician AssistantPA16731TX

General Provider Information

NPI Number : 1861196842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAILA BERGAIL WHERRY PA-C
Provider Business Mailing Address
First Line : 3737 GOLDMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75212-2471
Country : US
Telephone Number : 817-673-1152
Fax Number :
Provider Business Practice Location Address
First Line : 3737 GOLDMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75212-2471
Country : US
Telephone Number : 214-266-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2023
Last Update Date : 03/24/2024

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