Individual
PATRICIA L BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3705 MEDICAL PKWY, SUITE 570, AUSTIN, TX 78705-1019
(512) 454-2454
(512) 454-1532
Mailing address
3705 MEDICAL PKWY, SUITE 570, AUSTIN, TX 78705-1019
(512) 454-2454
(512) 454-1532
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
54613
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156417101
—
TX
05
—
156417105
—
TX
05
—
156417106
—
TX
01
—
527340YN3X
MEDICARE
TX
01
—
75-2771569-008
TRICARE
TX
01
—
82768U
BC/BS
TX
01
—
8GX972
BCBS
TX
01
—
P01803300
RAIL ROAD MEDICARE
TX
01
—
P01877265
MEDICARE RAIL ROAD
TX
Enumeration date
11/17/2005
Last updated
10/16/2017
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