Provider Demographics
NPI:1891744223
Name:BERGFELD, DEBORAH (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:BERGFELD
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 1:616 FM 1960 RD W
Mailing Address - Street 2:STE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3000
Mailing Address - Country:US
Mailing Address - Phone:888-749-7428
Mailing Address - Fax:281-724-3100
Practice Address - Street 1:5027 PECAN GROVE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3529
Practice Address - Country:US
Practice Address - Phone:210-333-6815
Practice Address - Fax:210-892-6481
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3608208100000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9042176OtherAETNA
NY02661356Medicaid
TX6052232OtherCIGNA
TX8DL376OtherBLUECROSS BLUE SHIELD
TXTXB164764Medicare PIN
TX8DL376OtherBLUECROSS BLUE SHIELD
TX9042176OtherAETNA
NY00419906Medicare PIN