Provider Demographics
NPI:1083045371
Name:BERGFELD PHYSICIAN SERVICES PA
Entity Type:Organization
Organization Name:BERGFELD PHYSICIAN SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERGFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-886-8099
Mailing Address - Street 1:616 FM 1960 RD W
Mailing Address - Street 2:STE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5027 PECAN GROVE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3529
Practice Address - Country:US
Practice Address - Phone:210-333-6815
Practice Address - Fax:210-892-6481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3608208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty