Provider Demographics
NPI:1275503641
Name:BERRY, CHRISTOPHER E (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:BERRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5501 LBJ FWY
Mailing Address - Street 2:STE 950
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-2362
Mailing Address - Country:US
Mailing Address - Phone:972-945-4600
Mailing Address - Fax:855-885-7652
Practice Address - Street 1:8390 LBJ FWY
Practice Address - Street 2:STE 1000B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1188
Practice Address - Country:US
Practice Address - Phone:972-945-4600
Practice Address - Fax:855-885-7652
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK23939207Q00000X
TXM9857207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AL611OtherBCBS
TX196197101Medicaid
TX8AL611OtherBCBS
TX8L1219Medicare PIN