Provider Demographics
NPI:1285644989
Name:JEANNETTE E. BURG
Entity Type:Organization
Organization Name:JEANNETTE E. BURG
Other - Org Name:OCCUPATIONAL THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURG
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, OTR
Authorized Official - Phone:281-446-0371
Mailing Address - Street 1:9810 FM 1960 BYPASS RD W
Mailing Address - Street 2:# 190
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3502
Mailing Address - Country:US
Mailing Address - Phone:281-446-0371
Mailing Address - Fax:281-446-4299
Practice Address - Street 1:9810 FM 1960 BYPASS RD W
Practice Address - Street 2:# 190
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3502
Practice Address - Country:US
Practice Address - Phone:281-446-0371
Practice Address - Fax:281-446-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1467488502OtherNPI