Provider Demographics
NPI:1114277639
Name:BURMAN, SUDEEP DUSTIN (DO)
Entity Type:Individual
Prefix:
First Name:SUDEEP
Middle Name:DUSTIN
Last Name:BURMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 JAMES CASEY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1189
Mailing Address - Country:US
Mailing Address - Phone:512-630-0070
Mailing Address - Fax:
Practice Address - Street 1:4319 JAMES CASEY ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1189
Practice Address - Country:US
Practice Address - Phone:512-630-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP38632086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery