Provider Demographics
NPI:1427551373
Name:BERG & MINIGUTTI, PLLC
Entity Type:Organization
Organization Name:BERG & MINIGUTTI, PLLC
Other - Org Name:WEST MCKINNEY HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-464-2510
Mailing Address - Street 1:4280 MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3080
Mailing Address - Country:US
Mailing Address - Phone:972-464-2510
Mailing Address - Fax:214-705-1379
Practice Address - Street 1:8000 EL DORADO PKWY
Practice Address - Street 2:BLDG D
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-464-2510
Practice Address - Fax:214-705-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3756207Q00000X
TXN0643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty