Provider Demographics
NPI:1235174566
Name:BERLER, MICHAEL H (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:BERLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 N MAIN AVE
Mailing Address - Street 2:101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5851
Mailing Address - Country:US
Mailing Address - Phone:210-733-7400
Mailing Address - Fax:210-733-1402
Practice Address - Street 1:2118 N MAIN AVE
Practice Address - Street 2:101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5851
Practice Address - Country:US
Practice Address - Phone:210-733-7400
Practice Address - Fax:210-733-1402
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-2592103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099005301Medicaid
TX00JD800Medicare PIN