MEDICARE: WILLIAM E BURNS JR M D, PLLC

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	207Q00000X	Family Medicine Physician	E6265	TX
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1225466253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM E BURNS JR M D, PLLC

Provider Business Mailing Address
First Line	:	208 OAK DR S STE 502
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5789
Country	:	US
Telephone Number	:	979-297-4507
Fax Number	:	979-480-9074

Provider Business Practice Location Address
First Line	:	208 OAK DR S STE 502
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5789
Country	:	US
Telephone Number	:	979-297-4507
Fax Number	:	979-480-9074

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PEGGY L CHRIST
Credential	:
Telephone Number	:	979-297-4507

Provider Enumeration Date	:	10/30/2013
Last Update Date	:	10/22/2024

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