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NPI Code Detail

MEDICARE: PAMELA BURRUS

MEDICARE:   PAMELA  BURRUS
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
1235Z00000XSpeech-Language Pathologist12637TX

General Provider Information

NPI Number : 1649589946
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA BURRUS
Provider Business Mailing Address
First Line : 8217 LONGFELLOW LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76120-5068
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8217 LONGFELLOW LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76120-5068
Country : US
Telephone Number : 817-801-5852
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2010
Last Update Date : 10/05/2010

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Directions to “ PAMELA BURRUS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.