MEDICARE: TARINA MICHELE BURDETTE RCP, RRT

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
1	227900000X	Registered Respiratory Therapist	84858	TX

General Provider Information

NPI Number	:	1083862718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARINA MICHELE BURDETTE RCP, RRT

Provider Business Mailing Address
First Line	:	11315 MAIN ST # 1402
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-5658
Country	:	US
Telephone Number	:	713-408-4794
Fax Number	:

Provider Business Practice Location Address
First Line	:	11315 MAIN ST # 1402
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-5658
Country	:	US
Telephone Number	:	713-408-4794
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2008
Last Update Date	:	08/03/2010

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