Provider Demographics
NPI:1801215512
Name:FAIRCHILD, BERRY (MD)
Entity Type:Individual
Prefix:
First Name:BERRY
Middle Name:
Last Name:FAIRCHILD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9230 KATY FWY STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7468
Mailing Address - Country:US
Mailing Address - Phone:713-489-5979
Mailing Address - Fax:
Practice Address - Street 1:9230 KATY FWY STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7468
Practice Address - Country:US
Practice Address - Phone:713-489-5979
Practice Address - Fax:713-512-2200
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS31632086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery