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General NPI Number Information
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NPI Number | 1154569648
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Entity Type | Individual
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Provider Name | HOWARD RAYMOND BURGESS MS
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Gender | Male
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 4500 S LANCASTER RD
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City | DALLAS
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State | TX
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Zip | 75216-7167
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Country | US
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Telephone | 214-857-0548
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Fax | 214-857-0549
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Provider Business Mailing Address
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Address Line | 1500 HAMPTON DR
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City | MANSFIELD
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State | TX
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Zip | 76063-7915
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Country | US
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Telephone | 214-857-0551
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Fax | 214-857-0549
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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