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General NPI Number Information
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NPI Number | 1093076093
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Entity Type | Individual
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Provider Name | GEORGE BURNETZ LPC
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Gender | Male
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 505 N. SAM HOUSTON PKWY SUITE 502
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City | HOUSTON
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State | TX
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Zip | 77060-4018
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Country | US
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Telephone | 281-201-5124
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Fax |
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Provider Business Mailing Address
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Address Line | 9734 LANSING MEADOWS
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City | HUMBLE
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State | TX
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Zip | 77396-4368
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Country | US
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Telephone | 713-232-0866
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 66929
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License Number State | TX
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