Individual
LLOYD STUART BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3501 MILLS AVE, AUSTIN, TX 78731-6309
(512) 324-2000
Mailing address
1601 RIO GRANDE ST STE 340, AUSTIN, TX 78701-1162
(512) 795-5500
(512) 795-3502
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
25608
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079974401
—
TX
05
—
096603804
—
TX
01
—
88061A
BCBS
TX
Enumeration date
07/12/2006
Last updated
12/14/2012
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