MEDICARE: MR. DOUGLAS DAVID HUNTER BURNS RNFA

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	163WR0006X	Registered Nurse First Assistant	600566	TX

General Provider Information

NPI Number	:	1811073117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DOUGLAS DAVID HUNTER BURNS RNFA

Provider Business Mailing Address
First Line	:	8104 BEAR CREEK DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-4401
Country	:	US
Telephone Number	:	512-680-3757
Fax Number	:	512-301-4579

Provider Business Practice Location Address
First Line	:	8104 BEAR CREEK DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78737-4401
Country	:	US
Telephone Number	:	512-680-3757
Fax Number	:	512-301-4579

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

Provider Enumeration Date	:	10/29/2006
Last Update Date	:	07/08/2007

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