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General NPI Number Information
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NPI Number | 1013266758
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Entity Type | Individual
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Provider Name | SETH V BURTON ATP
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Gender | Male
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 1101 W VICKERY BLVD
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City | FORT WORTH
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State | TX
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Zip | 76104-1025
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Country | US
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Telephone | 682-303-3116
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Fax | 682-885-5606
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Provider Business Mailing Address
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Address Line | PO BOX 99283
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City | FORT WORTH
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State | TX
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Zip | 76199-1383
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Country | US
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Telephone | 828-856-2946
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Fax | 682-885-5606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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