Provider Demographics
NPI:1275609943
Name:BURNS, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 E AUSTIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4104
Mailing Address - Country:US
Mailing Address - Phone:830-606-0955
Mailing Address - Fax:830-625-4956
Practice Address - Street 1:189 E AUSTIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4104
Practice Address - Country:US
Practice Address - Phone:830-606-0955
Practice Address - Fax:830-625-4956
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH41982084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G60KMedicare ID - Type Unspecified
TXE75043Medicare UPIN