Provider Demographics
NPI:1558595389
Name:BERGAL, LINDA MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MICHELLE
Last Name:BERGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:GALPERIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 N 11TH ST STE P3950
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1527
Mailing Address - Country:US
Mailing Address - Phone:409-892-0099
Mailing Address - Fax:409-892-1911
Practice Address - Street 1:755 N 11TH ST STE P3950
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1527
Practice Address - Country:US
Practice Address - Phone:409-892-0099
Practice Address - Fax:409-892-1911
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ5155208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program