Individual
PHILLIP L. BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 BARBARA JORDAN BLVD STE 200, AUSTIN, TX 78723-3078
(512) 628-1860
(512) 628-1861
Mailing address
1301 BARBARA JORDAN BLVD STE 200, AUSTIN, TX 78723-3078
(512) 628-1860
(512) 628-1861
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
E2466
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134858304
—
TX
Enumeration date
04/26/2006
Last updated
04/05/2013
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