Provider Demographics
NPI:1154355196
Name:BERNSTAM, ELMER V (MD)
Entity type:Individual
Prefix:
First Name:ELMER
Middle Name:V
Last Name:BERNSTAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 FANNIN ST STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-5400
Mailing Address - Country:US
Mailing Address - Phone:713-500-3900
Mailing Address - Fax:
Practice Address - Street 1:7000 FANNIN ST STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5400
Practice Address - Country:US
Practice Address - Phone:713-500-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150573701Medicaid
TX8F8253OtherBCBS
TX150573702OtherCSHCN
TXH03744Medicare UPIN
TX110236235Medicare PIN
TX150573702OtherCSHCN