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NPI Code Detail

MEDICARE: DR. CHRISTOPHER JASON BURNETT M.D.

MEDICARE: DR. CHRISTOPHER JASON BURNETT M.D.
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
1390200000XStudent in an Organized Health Care Education/Training ProgramM6552TX
2207LP2900XPain Medicine (Anesthesiology) PhysicianM6552TX

General Provider Information

NPI Number : 1376736785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER JASON BURNETT M.D.
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 1815 S 31ST ST
Second Line :
City : TEMPLE
State : TX
Zip : 76504-6728
Country : US
Telephone Number : 254-724-2111
Fax Number : 254-724-7603
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2007
Last Update Date : 12/02/2021

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