Individual
JON F BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 S I-35 EAST, DENTON, TX 76205
(940) 387-6159
(940) 382-3875
Mailing address
PO BOX 1888, GREENVILLE, TX 75403
(800) 945-2455
(903) 453-2541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E1502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136915904
—
TX
Enumeration date
05/17/2006
Last updated
05/19/2008
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