LIS CAROL BERNUY (NPI# 1154613735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154613735 |
| Entity Type | Individual |
| Full Name | LIS CAROL BERNUY |
| Other Name | LIS CAROL CRUZ |
| Credential | M.D. |
| Practice Address |
1612 W Villa Maria Rd Ste 130 Bryan TX 77807-2309 |
| Mailing Address |
2800 S Texas Ave Suite 202 Bryan TX 77802-5361 |
| Practice Telephone | 9796904836 |
| Practice Fax Number | 9796904837 |
| Mailing Telephone | 9797742060 |
| Mailing Fax Number | 9797765914 |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2019-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 64163 | CT | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | Q0413 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 4301098212 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 341070601 | 05 |
| Street Address |
1612 W VILLA MARIA RD STE 130 |
| City | BRYAN |
| State | TX |
| Zip Code | 77807-2309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174046270 | Cayla Henry Perez | Nurse Practitioner | 1612 W Villa Maria Rd Ste 130, Bryan, TX 77807-2310 | 2017-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558982298 | Kaylee Jackson | Psychologist | 8441 Hwy 47, St 1100, Bryan, TX 77807 | 2020-05-05 |
| 1457972192 | Melina Renee Cavazos | Psychologist | 8441 Highway 47, Clinical Building 1, Suite 1100, Bryan, TX 77807 | 2020-05-05 |
| 1891324448 | Radhika Shah | Student in an Organized Health Care Education/Training Program | 8447 Riverside Pkwy, Bryan, TX 77807 | 2020-04-06 |
| 1588648059 | Jerral Dewayne Taylor | Psychologist | 8441 Riverside Parkway, Clinical Building 1, Suite 1100, Bryan, TX 77807 | 2005-11-30 |
| 1457332959 | Robert Andrew Harper | Psychiatry & Neurology | 8441 Riverside Pkwy, Cb1, Suite 1400, Bryan, TX 77807 | 2005-11-10 |
| 1851918700 | Texas A&m University System Health Science Center | Nursing Care | 8441 Riverside Parkway, Ms 1359, Bryan, TX 77807 | 2020-06-26 |
| 1285255919 | Namrata Nanavaty | Psychologist | 8441 Riverside Parkway, Bryan, TX 77807 | 2020-05-05 |
| 1801422571 | Emily Kirsten Haque | Student in an Organized Health Care Education/Training Program | 8447 Riverside Parkway, 3081 Health Professions Education Building, Bryan, TX 77807 | 2020-03-13 |
| 1447885991 | Carly Elizabeth Mccord | Psychologist | 8441 Riverside Pkwy, Cb 1, Suite 1100, Bryan, TX 77807 | 2020-03-05 |
| 1639259088 | John M Hettema | Psychiatry & Neurology | 8441 Riverside Parkway, Cb1, Suite 1100, Bryan, TX 77807 | 2006-10-17 |
| Find all providers in zip 77807 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609333095 | Holly Ann Kleypas | Family Medicine | 1121 Briarcrest Dr Ste 303, Bryan, TX 77802-2500 | 2019-02-21 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1457898660 | Wellspring Physician, P.C. | Family Medicine | 309 N Washington Ave, Suite 13, Bryan, TX 77803-5368 | 2017-01-25 |
| 1700286986 | Michael D. Mckinney, Md. | Family Medicine | 3313 Emory Oak Dr, Bryan, TX 77807-4001 | 2014-08-25 |
| 1437558210 | Wellspring Physician, P.a. | Family Medicine | 309 N. Washington Ave, Suite 13, Bryan, TX 76248 | 2014-08-18 |
| 1639490089 | Kuy Houser | Family Medicine | 2800 S Texas Ave, Suite 202, Bryan, TX 77802-5361 | 2010-06-21 |
| 1275705089 | Michael F. Ruggiero, Do, Pa | Family Medicine | 2901 E 29th St, Suite 123, Bryan, TX 77802-2692 | 2008-04-01 |
| 1750572681 | Benjamin W. Dudycha | Family Medicine | 3351 University Dr E Ste 111, Bryan, TX 77802-3470 | 2007-08-06 |
| 1164634606 | Sybil Jane Taquet | Family Medicine | 2410 Boonville Rd, Bryan, TX 77808-2226 | 2007-05-04 |
| 1831259399 | Davelyn Eaves Hood | Family Medicine | 3370 South Texas Avenue, Suite B, Bryan, TX 77802 | 2006-12-12 |
| Find all providers in BRYAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.