Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Blake Berry, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1770287989

Blake Berry, MD is a Student in an Organized Health Care Education/Training Program in Fort Worth, Texas. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-3100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1770287989
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 30, 2023
Last updated in NPPESMarch 30, 2023
Certification dateMarch 30, 2023
Mailing address1500 S Main St, Fort Worth, TX 76104-4917

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