Provider Demographics
NPI:1417222159
Name:BERNAL, GINA (ARRT, ARDMS)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:BERNAL
Suffix:
Gender:F
Credentials:ARRT, ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 HUEY
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-1606
Mailing Address - Country:US
Mailing Address - Phone:210-827-0096
Mailing Address - Fax:
Practice Address - Street 1:1022 HUEY
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-1606
Practice Address - Country:US
Practice Address - Phone:210-827-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3282202471C3402X
CA1184512471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography