Individual provider · NPI-1

Byron Berry

Private Vehicle · Dallas, TX

NPI number1770213464
StatusActive
Last updated in NPPESJun 15, 2022

Details

NPI
1770213464
Entity type
Individual (NPI-1)
Name
Byron Berry
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 15, 2022
Certification date
Jun 15, 2022
Last updated
Jun 15, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
347C00000X Private Vehicle––Yes
343900000X Non-emergency Medical Transport (VAN)––

Practice location

18211 Kelly Blvd Apt 1313
Dallas, TX 75287-4639

Phone 205-370-4147

Mailing address

18211 Kelly Blvd Apt 1313
Dallas, TX 75287-4639

Phone 205-370-4147

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