Provider Demographics
NPI:1174785604
Name:SERBER, JULIA (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:SERBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ENCHANTED WAY
Mailing Address - Street 2:STE. 100
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-0965
Mailing Address - Country:US
Mailing Address - Phone:682-223-5553
Mailing Address - Fax:817-796-1987
Practice Address - Street 1:1900 ENCHANTED WAY
Practice Address - Street 2:STE. 100
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-0965
Practice Address - Country:US
Practice Address - Phone:682-223-5553
Practice Address - Fax:817-796-1987
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ9031207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program