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General NPI Number Information
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NPI Number | 1043441355
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Entity Type | Organization
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Legal Business Name | SOPHIA L BURNS MD PA
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 740 HOSPITAL DR SUITE 250
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City | BEAUMONT
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State | TX
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Zip | 77701-4664
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Country | US
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Telephone | 409-212-9117
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Fax | 409-212-1003
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Provider Business Mailing Address
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Address Line | 740 HOSPITAL DR SUITE 250
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City | BEAUMONT
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State | TX
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Zip | 77701-4664
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Country | US
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Telephone | 409-212-9117
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Fax | 409-212-1003
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Authorized Official
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Title or Position | OWNER
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Name | SOPHIA L BURNS
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Credential | MD
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Telephone | 409-212-9117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | J1449
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License Number State | TX
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