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General NPI Number Information
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NPI Number | 1467488502
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Entity Type | Organization
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Legal Business Name | JEANNETTE E. BURG
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 9810 FM 1960 BYPASS RD W # 190
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City | HUMBLE
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State | TX
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Zip | 77338-3522
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Country | US
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Telephone | 281-446-0371
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Fax | 281-446-4299
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Provider Business Mailing Address
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Address Line | 9810 FM 1960 BYPASS RD W # 190
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City | HUMBLE
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State | TX
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Zip | 77338-3522
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Country | US
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Telephone | 281-446-0371
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Fax | 281-446-4299
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Authorized Official
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Title or Position | OWNER
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Name | JEANNETT BURG
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Credential | PHD
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Telephone | 281-446-0371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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