Basic Information
| Provider Information | |||||||||
| NPI: | 1891049250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | KRISTA | ||||||||
| MiddleName: | |||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2967 OAK RUN PKWY STE 505 | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781325379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105982800 | ||||||||
| FaxNumber: | 2105982800 | ||||||||
| Practice Location | |||||||||
| Address1: | 2967 OAK RUN PKWY STE 505 | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781325379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105982800 | ||||||||
| FaxNumber: | 2105982800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2012 | ||||||||
| LastUpdateDate: | 03/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 50-003656 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.