1891835195 NPI number — DR. PHILIP LEONARD BERMAN MD FACC

Table of content: DR. PHILIP LEONARD BERMAN MD FACC (NPI 1891835195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891835195 NPI number — DR. PHILIP LEONARD BERMAN MD FACC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERMAN
Provider First Name:
PHILIP
Provider Middle Name:
LEONARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD FACC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERMAN
Provider Other First Name:
PHILIP
Provider Other Middle Name:
LEONARD
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD FACC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1891835195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
915 GESSNER RD
Provider Second Line Business Mailing Address:
SUITE 900
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-2527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-464-6006
Provider Business Mailing Address Fax Number:
713-464-1272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
915 GESSNER RD
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-2527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-464-6006
Provider Business Practice Location Address Fax Number:
713-464-1272
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  G4825 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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