Provider Demographics
NPI:1659456226
Name:BERMAN, MEGAN ANNE (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANNE
Last Name:BERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:ROOM 4.174 JSA ROUTE #0566
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-4182
Mailing Address - Fax:409-772-6507
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:ROOM 4.174 JSA ROUTE #0566
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-772-4182
Practice Address - Fax:409-772-6507
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM9158207R00000X
SC27211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC272118Medicaid
P00434697OtherRR MEDICARE
P00434697OtherRR MEDICARE
TX8K6826Medicare PIN