Individual ProviderPatricia L BerghNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019(512) 454-2454PECOS EnrollmentBased on the most recent information from CMS, provider Patricia L Bergh does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1326020116Provider TypeIndividualFull NameBergh, Patricia LCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date11/17/2005Last Updated10/16/2017Contact InformationPractice LocationPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Mailing LocationMailing Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense54613TexasProvider IdentifiersIDDescriptionIssuerID75-2771569-008DescriptionOtherIssuerTRICARETexasID82768UDescriptionOtherIssuerBC/BSTexasIDP01803300DescriptionOtherIssuerRAIL ROAD MEDICARETexasID156417106DescriptionMedicaidIssuerUnlistedTexasID527340YN3XDescriptionOtherIssuerMEDICARETexasID8GX972DescriptionOtherIssuerBCBSTexasID156417105DescriptionMedicaidIssuerUnlistedTexasIDP01877265DescriptionOtherIssuerMEDICARE RAIL ROADTexasID156417101DescriptionMedicaidIssuerUnlistedTexas