Provider Demographics
NPI:1295761104
Name:BERNSTEIN, MELVYN LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:LOUIS
Last Name:BERNSTEIN
Suffix:
Gender:M
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:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76095-0826
Mailing Address - Country:US
Mailing Address - Phone:817-569-0296
Mailing Address - Fax:
Practice Address - Street 1:2309 FOLKSTONE WAY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-7971
Practice Address - Country:US
Practice Address - Phone:817-975-5685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3579207R00000X, 207RE0101X, 207WX0109X, 207WX0120X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00818066Medicaid
NY00818066Medicaid
NY45A411Medicare ID - Type Unspecified
TXBE087742Medicare ID - Type Unspecified