Provider Demographics
NPI:1891835195
Name:BERMAN, PHILIP LEONARD (MD FACC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:LEONARD
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:DR
Other - First Name:PHILIP
Other - Middle Name:LEONARD
Other - Last Name:BERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD FACC
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-464-6006
Mailing Address - Fax:713-464-1272
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 900
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-464-6006
Practice Address - Fax:713-464-1272
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4825207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
C13403Medicare UPIN
TX8280K0Medicare ID - Type Unspecified