Organization
RNL BERWICK IM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A GLEN BERWICK M.D. (OWNER)
(936) 760-7850
Entity
Organization
Contact information
Practice address
690 S LOOP 336 W, SUITE 3050, CONROE, TX 77304-3318
(936) 760-7850
(936) 521-7396
Mailing address
690 S LOOP 336 W, SUITE 3050, CONROE, TX 77304-3318
(936) 760-7850
(936) 521-7396
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E6039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1151946-02.
—
TX
Enumeration date
06/14/2012
Last updated
10/30/2012
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