Healthcare Provider Details

I. General information

NPI: 1023315256
Provider Name (Legal Business Name): GARY R BURMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15035 EAST FWY STE D
CHANNELVIEW TX
77530-4151
US

IV. Provider business mailing address

15035 EAST FWY STE D
CHANNELVIEW TX
77530-4151
US

V. Phone/Fax

Practice location:
  • Phone: 281-457-0477
  • Fax: 281-457-6238
Mailing address:
  • Phone: 281-457-0477
  • Fax: 281-457-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ1204
License Number StateTX

VIII. Authorized Official

Name: GARY R BURMAN
Title or Position: DOCTOR
Credential: M.D.
Phone: 281-457-0477