Provider Demographics
NPI:1093076093
Name:BURNETZ, GEORGE (LPC)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:BURNETZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9734 LANSING MEADOWS
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4368
Mailing Address - Country:US
Mailing Address - Phone:713-232-0866
Mailing Address - Fax:
Practice Address - Street 1:505 N. SAM HOUSTON PKWY
Practice Address - Street 2:SUITE 502
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4018
Practice Address - Country:US
Practice Address - Phone:281-201-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional