Bergeron, Diane E
Bergeron, Diane E is an individual health care provider with primary practice located at 1111 Medical Plaza Dr 250, The Woodlands TX 77380-3240. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bergeron, Diane E can be contacted via phone (281) 296-8788.Contact Information
Primary practice address
1111 Medical Plaza Dr 250
The Woodlands TX 77380-3240
Phone: (281) 296-8788
Fax: (281) 419-1291
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 626794 | Texas |
Profile Details
| NPI number | 1306018148 |
|---|---|
| LBN Legal business name | Bergeron, Diane E |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 1st, 2008 |
| Last updated | Jul 6th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306018148 | NPPES |
| Texas | MEDICAID | 193009102 | |
| Texas | MEDICAID | 154240902 |
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