MEDICARE: LYNDSEY BURIAK PA-C

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	PA07851	TX
2	363A00000X	Physician Assistant	PA07851	TX

General Provider Information

NPI Number	:	1629432034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDSEY BURIAK PA-C

Provider Business Mailing Address
First Line	:	451 KINGWOOD MEDICAL DR
Second Line	:	STE 200
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6408
Country	:	US
Telephone Number	:	281-359-2080
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 KINGWOOD MEDICAL DR STE 200
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-6408
Country	:	US
Telephone Number	:	281-593-2421
Fax Number	:

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

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	01/09/2024

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