Organization
JOAN L BERGSTROM, MD PA
Active
Organization
JOAN L BERGSTROM, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN L BERGSTROM M.D. (CEO)
(817) 277-9415
Entity
Organization
Contact information
Practice address
1001 N WALDROP DR, SUITE 505, ARLINGTON, TX 76012-4705
(817) 277-9415
(817) 277-0360
Mailing address
1001 N WALDROP DR, SUITE 505, ARLINGTON, TX 76012-4705
(817) 277-9415
(817) 277-0360
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
G8579
TX
261QM1300X
Multi-Specialty Clinic/Center
L0505
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245214550
DR. PEPPLERS NPI
TX
01
—
1396727814
DR. BERGSTROMS NPI
TX
Enumeration date
04/13/2007
Last updated
02/22/2016
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