Provider Demographics
NPI:1124018163
Name:BERKOWITZ, CARL M (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:M
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8042 WURZBACH RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3818
Mailing Address - Country:US
Mailing Address - Phone:210-614-8100
Mailing Address - Fax:210-568-0311
Practice Address - Street 1:8042 WURZBACH RD
Practice Address - Street 2:SUITE 280
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3818
Practice Address - Country:US
Practice Address - Phone:210-614-8100
Practice Address - Fax:210-568-0311
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2020-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG9261207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127715406Medicaid
TX8A5994Medicare ID - Type Unspecified
C13401Medicare UPIN