Provider Demographics
NPI:1720087174
Name:BERCHER, PAUL RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:RICHARD
Last Name:BERCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:RICHARD
Other - Last Name:BERCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1055 CLARKSVILLE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-6097
Mailing Address - Country:US
Mailing Address - Phone:903-739-7700
Mailing Address - Fax:903-739-7989
Practice Address - Street 1:140 S COLLEGIATE DR STE 100
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6319
Practice Address - Country:US
Practice Address - Phone:903-783-1818
Practice Address - Fax:903-739-8370
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0057GUOtherBLUE CROSS
OK100075750AOtherMEDICAID OKLAHOMA
TX080181554OtherRAILROAD MEDICARE
TX126295807Medicaid
TX8F23594Medicare PIN
TX0057GUOtherBLUE CROSS