Individual
DEAINA M. BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J7306
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139121101
—
TX
05
—
139121102
—
TX
05
—
139121103
—
TX
05
—
139121104
—
TX
05
—
139121105
—
TX
05
—
139121107
—
TX
05
—
139121108
—
TX
05
—
139121109
—
TX
05
—
139121110
—
TX
05
—
139121112
—
TX
05
—
139121113
—
TX
05
—
139121114
—
TX
01
—
8U7231
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/09/2005
Last updated
11/10/2012
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