Individual provider Active NPI

Denis Eugene Bergeron Jr., M.D.

  • Internal Medicine Physician
  • Pasadena, TX
National Provider Identifier
1083639462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E3178 Issued in TX
Practice address
3325 Plainview St
#1
Pasadena, TX 77504-1989
Phone
(713) 947-8837
Fax
(713) 947-1195
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E3178 TX Primary

Addresses

Primary practice location

3325 Plainview St
#1
Pasadena, TX 77504-1989

Mailing address

3325 Plainview St
#1
Pasadena, TX 77504-1989
Phone (713) 947-8837

Other identifiers 1

IdentifierTypeStateIssuer
034265101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028001135 TX Practitioner - Internal Medicine 8123212636 Practice locations: Pasadena, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083639462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 PLAINVIEW ST",
            "address_2": "#1",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041989",
            "telephone_number": "713-947-8837",
            "fax_number": "713-947-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 PLAINVIEW ST",
            "address_2": "#1",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041989",
            "telephone_number": "713-947-8837",
            "fax_number": "713-947-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "DENIS",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E3178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034265101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.