Healthcare Provider Details

I. General information

NPI: 1861574147
Provider Name (Legal Business Name): JOHN THOMAS BURNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14903 EL CAMINO REAL
HOUSTON TX
77062-2603
US

IV. Provider business mailing address

PO BOX 2206
LEAGUE CITY TX
77574-2206
US

V. Phone/Fax

Practice location:
  • Phone: 713-622-8382
  • Fax: 281-334-6853
Mailing address:
  • Phone: 713-622-8382
  • Fax: 281-334-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberD4941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: