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General NPI Number Information
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NPI Number | 1952359135
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Entity Type | Individual
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Provider Name | ROBERT D BURGOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 2300 LONE STAR RD
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City | MANSFIELD
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State | TX
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Zip | 76063-8744
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Country | US
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Telephone | 682-341-7210
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Fax | 682-341-7212
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Provider Business Mailing Address
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Address Line | PO BOX 6278
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City | FORT WORTH
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State | TX
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Zip | 76115-0278
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Country | US
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Telephone | 817-568-5459
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Fax | 817-568-5474
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | H4879
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H4879
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License Number State | TX
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