Provider Demographics
NPI:1386646594
Name:BERGMAN, KARIN KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:KAY
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 WARREN PKWY STE 705
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7463
Mailing Address - Country:US
Mailing Address - Phone:214-494-6200
Mailing Address - Fax:214-494-6075
Practice Address - Street 1:5150 WARREN PKWY STE 705
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7463
Practice Address - Country:US
Practice Address - Phone:214-494-6200
Practice Address - Fax:214-494-6075
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3582207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0035JEOtherBCBS PROVIDER ID
TX2984668OtherAETNA PROVIDER ID
TX2984668OtherAETNA PROVIDER ID