Provider Demographics
NPI:1811689573
Name:BERALAS, JOHN PRESTON
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PRESTON
Last Name:BERALAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10031 ANGELINA WOODS LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-1537
Mailing Address - Country:US
Mailing Address - Phone:808-635-7987
Mailing Address - Fax:
Practice Address - Street 1:1610 WOODSTEAD CT STE 420
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3404
Practice Address - Country:US
Practice Address - Phone:281-363-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional