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Individual
LEONARD AUTWOOD BERRY JR.
Active
Individual
LEONARD AUTWOOD BERRY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H3620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1393175 17
—
TX
01
—
8BN470
BCBS
TX
Enumeration date
11/23/2005
Last updated
02/27/2012
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