Provider Demographics
NPI:1053499301
Name:BERLIN, ALEXANDER L (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:L
Last Name:BERLIN
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 1:1115 W RANDOL MILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2577
Mailing Address - Country:US
Mailing Address - Phone:817-303-6647
Mailing Address - Fax:817-303-6651
Practice Address - Street 1:1115 W RANDOL MILL RD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2577
Practice Address - Country:US
Practice Address - Phone:817-303-6647
Practice Address - Fax:817-303-6651
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3492207NS0135X, 207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery