Provider Demographics
NPI:1417191545
Name:MARCY L. BERRY, MD, PA
Entity Type:Organization
Organization Name:MARCY L. BERRY, MD, PA
Other - Org Name:A BRIGHT FUTURE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-208-8668
Mailing Address - Street 1:2100 HEDGCOXE RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3156
Mailing Address - Country:US
Mailing Address - Phone:972-208-8668
Mailing Address - Fax:972-208-3186
Practice Address - Street 1:2100 HEDGCOXE RD
Practice Address - Street 2:SUITE 190
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3156
Practice Address - Country:US
Practice Address - Phone:972-208-8668
Practice Address - Fax:972-208-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8005208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty