Bergeron, Jon A.

Bergeron, Jon A. is an sole proprietor health care provider with primary practice located at 16741 Woodlake Dr , College Station TX 77845-8273. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bergeron, Jon A. can be contacted via phone (979) 575-5198.

Contact Information

Primary practice address
16741 Woodlake Dr College Station TX 77845-8273
Phone: (979) 575-5198
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 31998 Texas

Profile Details

NPI number 1568422707
LBN Legal business name Bergeron, Jon A.
Credentials P.H.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2006
Last updated Nov 25th, 2013 - about 11 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 1568422707 NPPES
Texas MEDICAID 1596470-01
Texas Other P00028151
Texas Other 86790A

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