Berg, Bradley R.

Berg, Bradley R. is an individual health care provider with primary practice located at 425 University Blvd , Round Rock TX 78665-1053. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Berg, Bradley R. can be contacted via phone (512) 509-0200.

Contact Information

Primary practice address
425 University Blvd Round Rock TX 78665-1053
Phone: (512) 509-0200
Fax: (512) 218-6330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00043078 Washington
Allopathic & Osteopathic Physicians / Pediatrics 208000000X N5567 Texas

Profile Details

NPI number 1871589929
LBN Legal business name Berg, Bradley R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Dec 6th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871589929 NPPES
Washington Other 263645 LABOR & INDUSTRIES
Washington MEDICAID 8371452 LABOR & INDUSTRIES

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