Provider Demographics
NPI:1467832097
Name:BERNARD, DORLENA
Entity Type:Individual
Prefix:
First Name:DORLENA
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 W PIONEER DR APT 340
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-3729
Mailing Address - Country:US
Mailing Address - Phone:323-537-0731
Mailing Address - Fax:
Practice Address - Street 1:4604 W PIONEER DR APT 340
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-3729
Practice Address - Country:US
Practice Address - Phone:323-537-0731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other