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General NPI Number Information
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NPI Number | 1477264489
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Entity Type | Individual
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Provider Name | MADISON BURCH
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Gender | Female
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 1919 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85016-7710
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Country | US
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Telephone | 602-933-1900
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Fax | 602-933-1918
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Provider Business Mailing Address
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Address Line | 315 N SAN SABA
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City | SAN ANTONIO
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State | TX
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Zip | 78207-3154
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Country | US
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Telephone | 210-704-4275
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19544
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10003
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License Number State | AZ
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