Individual
MR. DAVID BERARDELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16607 BLANCO ROAD, SUITE 303, SAN ANTONIO, TX 78232-1940
(361) 230-0466
(210) 493-9504
Mailing address
16607 BLANCO ROAD, SUITE 303, SAN ANTONIO, TX 78232-1940
(361) 230-0466
(210) 493-9504
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
209-10982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-10982
TEXAS BOARD OF ORTHOTISTS AND PROSTHECS LICENSE AND CONTROL #
TX
01
—
C21287
BOARD FOR ORTHOTISTS AND PROSTHISTS CERTIFICATION
TX
Enumeration date
01/08/2010
Last updated
01/08/2010
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