| Joan L Bergstrom, Md Pa | |
|
1001 N Waldrop Dr Suite 505 Arlington TX 76012-4705 | |
| (817) 277-9415 | |
| (817) 277-0360 |
| Full Name | Joan L Bergstrom, Md Pa |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1001 N Waldrop Dr, Arlington, Texas |
| Authorized Official Name and Position | Joan L Bergstrom (CEO) |
| Authorized Official Contact | 8172779415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joan L Bergstrom, Md Pa 1001 N Waldrop Dr Suite 505 Arlington TX 76012-4705 Ph: (817) 277-9415 | Joan L Bergstrom, Md Pa 1001 N Waldrop Dr Suite 505 Arlington TX 76012-4705 Ph: (817) 277-9415 |
| NPI Number | 1164647434 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 02/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164647434 | NPI | - | NPPES |
| 1245214550 | Other | TX | DR. PEPPLERS NPI |
| 1396727814 | Other | TX | DR. BERGSTROMS NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | G8579 (Texas) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | L0505 (Texas) | Secondary |
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