Healthcare Provider Details
I. General information
NPI: 1174985840
Provider Name (Legal Business Name): KENDALL CATHERINE BURNS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/22/2016
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4900 MUELLER BLVD
AUSTIN TX
78723-3051
US
IV. Provider business mailing address
4900 MUELLER BLVD
AUSTIN TX
78723-3051
US
V. Phone/Fax
- Phone: 512-324-0165
- Fax: 512-324-0786
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | S0851 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: