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NPI Code Detail

MEDICARE: EVELYN BURNETT

MEDICARE: EVELYN BURNETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374J00000XDoula

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127629320OTHERTXDRIVERS LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073156154
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN BURNETT
Provider Business Mailing Address
First Line : 1119 NOGALES BEND DR
Second Line :
City : RICHMOND
State : TX
Zip : 77469-6129
Country : US
Telephone Number : 713-677-1500
Fax Number :
Provider Business Practice Location Address
First Line : 1119 NOGALES BEND DR
Second Line :
City : RICHMOND
State : TX
Zip : 77469-6129
Country : US
Telephone Number : 713-677-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2019
Last Update Date : 12/01/2019

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Directions to “ EVELYN BURNETT ” Practice Location

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