MEDICARE: HUGH B BURRIS JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	D9376	TX
2	207Q00000X	Family Medicine Physician	D9376	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F9293	OTHER	TX	BCBSTX PROV NO
2	1407831225	OTHER	TX	BCBSTX
3	1407831225	OTHER	TX	TRICARE SOUTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407831225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUGH B BURRIS JR. M.D.

Provider Business Mailing Address
First Line	:	1202 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3304
Country	:	US
Telephone Number	:	281-335-0606
Fax Number	:	281-335-0208

Provider Business Practice Location Address
First Line	:	1202 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3304
Country	:	US
Telephone Number	:	281-335-0606
Fax Number	:	281-335-0208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	02/12/2020

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