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General NPI Number Information
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NPI Number | 1255416905
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Entity Type | Individual
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Provider Name | GRANT L BURTON JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 7777 FOREST LN STE C300J
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City | DALLAS
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State | TX
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Zip | 75230-2604
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Country | US
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Telephone | 972-566-2043
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Fax | 972-566-7437
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN STE C300J
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City | DALLAS
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State | TX
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Zip | 75230-2604
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Country | US
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Telephone | 972-566-2043
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Fax | 972-566-7437
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | P4290
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 44019
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | P4290
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | P4290
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License Number State | TX
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