Provider Demographics
NPI:1669517728
Name:BERGER & BERGER, PHDS, PC
Entity type:Organization
Organization Name:BERGER & BERGER, PHDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-692-5793
Mailing Address - Street 1:11551 FOREST CENTRAL DR
Mailing Address - Street 2:123
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3920
Mailing Address - Country:US
Mailing Address - Phone:214-692-5793
Mailing Address - Fax:214-368-7311
Practice Address - Street 1:11551 FOREST CENTRAL DR
Practice Address - Street 2:123
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3920
Practice Address - Country:US
Practice Address - Phone:214-692-5793
Practice Address - Fax:214-368-7311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX367101YM0800X
TX2-3297103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0952467-01Medicaid
TX0326001-01Medicaid
TX0326001-01Medicaid
TX00D12RMedicare PIN