Provider Demographics
NPI:1194276683
Name:BIEN-AIME, BERTHONY (ARNP)
Entity type:Individual
Prefix:
First Name:BERTHONY
Middle Name:
Last Name:BIEN-AIME
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11246 SIR WINSTON ST
Mailing Address - Street 2:401
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5450
Mailing Address - Country:US
Mailing Address - Phone:210-309-7243
Mailing Address - Fax:
Practice Address - Street 1:11246 SIR WINSTON ST
Practice Address - Street 2:401
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5450
Practice Address - Country:US
Practice Address - Phone:210-309-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily