Individual
ALFRED GLEN BERWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
508 MEDICAL CENTER BLVD, SUITE 200, CONROE, TX 77304-2808
(936) 760-4600
(936) 760-4601
Mailing address
508 MEDICAL CENTER BLVD, SUITE 200, CONROE, TX 77304-2808
(936) 760-4600
(936) 760-4601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E6039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115194602
—
TX
Enumeration date
07/22/2006
Last updated
11/15/2012
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