MEDICARE: DR. CHRISTOPHER MICHAEL BURLING MD

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	K7676	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45D1016874	OTHER	TX	CILIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295732832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MICHAEL BURLING MD

Provider Business Mailing Address
First Line	:	618 N JEFFERSON AVE
Second Line	:	STE 1
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-3647
Country	:	US
Telephone Number	:	903-575-9500
Fax Number	:	903-575-9866

Provider Business Practice Location Address
First Line	:	618 N JEFFERSON AVE
Second Line	:	STE 1
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-3647
Country	:	US
Telephone Number	:	903-575-9500
Fax Number	:	903-575-9866

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	01/29/2010

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