Provider Demographics
NPI:1184845315
Name:SURGICAL ASSOCIATES OF KERRVILLE
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF KERRVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-896-6262
Mailing Address - Street 1:251 CULLY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6083
Mailing Address - Country:US
Mailing Address - Phone:830-896-6262
Mailing Address - Fax:830-896-6269
Practice Address - Street 1:251 CULLY DR
Practice Address - Street 2:SUITE B
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6083
Practice Address - Country:US
Practice Address - Phone:830-896-6262
Practice Address - Fax:830-896-6269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty