Individual
EDWARD BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-5818
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-5818
Taxonomy
Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
Primary
64979
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
08/03/2021
Last updated
08/03/2021
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