Individual
DR. ALISA MARIE BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
115 ABNER JACKSON PKWY STE C, LAKE JACKSON, TX 77566-5157
(979) 297-4140
(979) 297-4919
Mailing address
115 ABNER JACKSON PKWY STE C, LAKE JACKSON, TX 77566-5157
(979) 297-4140
(979) 297-4919
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01084523A
IN
208800000X
Urology Physician
82525
WI
208800000X
Urology Physician
M5052
TX
208800000X
Urology Physician
MD-46471
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192360901
—
TX
Enumeration date
02/07/2007
Last updated
08/28/2023
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