Healthcare Provider Details

I. General information

NPI: 1285644989
Provider Name (Legal Business Name): JEANNETTE E. BURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9810 FM 1960 BYPASS RD W # 190
HUMBLE TX
77338-3502
US

IV. Provider business mailing address

9810 FM 1960 BYPASS RD W # 190
HUMBLE TX
77338-3502
US

V. Phone/Fax

Practice location:
  • Phone: 281-446-0371
  • Fax: 281-446-4299
Mailing address:
  • Phone: 281-446-0371
  • Fax: 281-446-4299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEANNETTE E. BURG
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: EDD, OTR
Phone: 281-446-0371