J Bergeron MD PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

J BERGERON MD PA

Doing business as

Wellcare Clinic

Practice address

1961 W TC Jester Blvd
Houston, TX 77008-1256

Phone

(713) 225-9355

Fax

(713) 861-8970

NPI assigned

Sep 10, 2007

Last updated

Sep 10, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Bergeron, MDNPI 1376690503

Title

Medical Director/Owner

Phone

(713) 225-9355

Specialties & licenses 1

Addresses

Other names 1

• Wellcare Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Bergeron, MD

  • Specialist
  • Houston, TX
  • NPI 1376690503
  Authorized official Same address or phone

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1083809339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1961 W TC JESTER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081256",
            "telephone_number": "713-225-9355",
            "fax_number": "713-861-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 W TC JESTER BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081256",
            "telephone_number": "713-225-9355",
            "fax_number": "713-861-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J BERGERON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "713-225-9355",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.