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NPI Code Detail

MEDICARE: LISA BURR N.P.

MEDICARE: LISA BURR N.P.
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
1363L00000XNurse Practitioner542364TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962413716
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA BURR N.P.
Provider Business Mailing Address
First Line : 3706 S 1ST ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-7046
Country : US
Telephone Number : 512-324-4973
Fax Number : 512-324-4948
Provider Business Practice Location Address
First Line : 2811 E 2ND ST
Second Line :
City : AUSTIN
State : TX
Zip : 78702-4843
Country : US
Telephone Number : 512-324-4930
Fax Number : 512-324-2929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 07/08/2007

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Directions to “ LISA BURR N.P.” Practice Location

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