Sue Ann Berend, PH.D.

Individual provider Active NPI Ph.D. Medical Genetics · Henrietta, TX

NPI 1043403231 · NPPES record last updated Nov 30, 2022

Key facts

NPI
1043403231
Entity type
Individual (NPI type 1)
Primary specialty
Ph.D. Medical Genetics 170100000X
License
DI38592 (FL)
Practice address
1471 Raymond Edwards Rd
Henrietta, TX 76365-7297
Phone
(505) 690-8357
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DI38592FLMDPh.D. Medical Genetics

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X DI38592 FL Yes

Addresses

Primary practice location

1471 Raymond Edwards Rd
Henrietta, TX 76365-7297

Mailing address

1471 Raymond Edwards Rd
Henrietta, TX 76365-7297
Phone (505) 690-8357

Other identifiers

IdentifierTypeStateIssuer
BERES1OtherNYDEPT. OF HEALTH
DI38592OtherFLDEPT. OF HEALTH
DRM42OtherCADEPT. OF HEALTH SERVICES

Other providers in Henrietta, TX

All providers in Henrietta, TX · Ph.D. Medical Genetics in Texas

Sources for this page

Verify at the official NPI Registry.