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General NPI Number Information
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NPI Number | 1811182389
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Entity Type | Organization
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Legal Business Name | ELVIRA C BURNS, MD PA
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 2102 W TENNESSEE AVE
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City | MIDLAND
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State | TX
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Zip | 79701-5933
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Country | US
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Telephone | 432-686-0133
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Fax | 432-686-0937
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Provider Business Mailing Address
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Address Line | 2102 W TENNESSEE AVE
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City | MIDLAND
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State | TX
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Zip | 79701-5933
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Country | US
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Telephone | 432-686-0133
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Fax | 432-686-0937
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Authorized Official
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Title or Position | OWNER
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Name | ELVIRA CANALES BURNS
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Credential | MD
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Telephone | 432-686-0133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | H0219
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License Number State | TX
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