Bertzyk, Tarah R

Bertzyk, Tarah R is an individual health care provider with primary practice located at 123 S Ranch House Rd , Willow Park TX 76008-2649. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Medical. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bertzyk, Tarah R can be contacted via phone (817) 984-7120.

Contact Information

Primary practice address
123 S Ranch House Rd Willow Park TX 76008-2649
Phone: (817) 984-7120
Fax: (817) 984-7121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X PA06239 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PA06239 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA06239 Texas

Profile Details

NPI number 1922238831
LBN Legal business name Bertzyk, Tarah R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2009
Last updated Dec 2nd, 2015 - about 9 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 1922238831 NPPES
Texas Other 390958ZMEG MEDICARE PTAN

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