Provider Demographics
NPI:1598833345
Name:BILL H BERRYHILL MDPA
Entity Type:Organization
Organization Name:BILL H BERRYHILL MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:H
Authorized Official - Last Name:BERRYHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-776-0310
Mailing Address - Street 1:7003 WOODWAY DR
Mailing Address - Street 2:STE 310
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6163
Mailing Address - Country:US
Mailing Address - Phone:254-776-0310
Mailing Address - Fax:254-776-7815
Practice Address - Street 1:7003 WOODWAY DR
Practice Address - Street 2:STE 310
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6163
Practice Address - Country:US
Practice Address - Phone:254-776-0310
Practice Address - Fax:254-776-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9067207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0045QPOtherBLUE CROSS BLUE SHIELD
TX0045QPOtherBLUE CROSS BLUE SHIELD
B21232Medicare UPIN