| Doctor Name: | MS. TARAH R BERTZYK |
| NPI Number: | 1922238831 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | PA06239 |
| Business Practice Address: | 123 S Ranch House Rd Willow Park, TX - 760082649 |
| Business Phone Number: | 8179847120 |
| Business Fax Number: | 8179847121 |
| Mailing Address: | 123 S Ranch House Rd, WILLOW PARK |
| State: | TX |
| Postal Code: | 760082649 |
| Phone Number: | 8179847120 |
| Fax Number: | 8179847121 |
| NPI Enumeration Date: | 07/27/2009 |
| NPI Last Update Date: | 12/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PE0004X |
| License Number: | PA06239 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Emergency Medical Services |
| Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |