Provider Demographics
NPI:1134474380
Name:BURKHOLDER, HENRY LEROY IV (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:LEROY
Last Name:BURKHOLDER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13100 WORTHAM CENTER DR FL 3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5625
Mailing Address - Country:US
Mailing Address - Phone:281-843-8441
Mailing Address - Fax:
Practice Address - Street 1:17450 ST LUKES WAY STE 230
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8045
Practice Address - Country:US
Practice Address - Phone:281-843-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN7062207Q00000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine