MEDICARE: HANNAH BURFIELD

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	152W00000X	Optometrist	9680	TX

General Provider Information

NPI Number	:	1144880998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH BURFIELD

Provider Business Mailing Address
First Line	:	448 W 19TH ST UNIT 788
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-3914
Country	:	US
Telephone Number	:	512-771-3512
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 CLEAR LAKE CITY BLVD STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-8040
Country	:	US
Telephone Number	:	281-480-1002
Fax Number	:	281-480-1048

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

Provider Enumeration Date	:	06/14/2019
Last Update Date	:	10/01/2020

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