Bergstrom, Jon F

Bergstrom, Jon F is an individual health care provider with primary practice located at 3535 S I-35 East , Denton TX 76205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bergstrom, Jon F can be contacted via phone (940) 387-6159.

Contact Information

Primary practice address
3535 S I-35 East Denton TX 76205
Fax: (940) 382-3875
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X E1502 Texas

Profile Details

NPI number 1164474847
LBN Legal business name Bergstrom, Jon F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated May 19th, 2008 - about 16 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 1164474847 NPPES
Texas MEDICAID 136915904

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