Provider Demographics
NPI:1295864981
Name:BURGESS, DAVID S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:BURGESS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8614 QUEEN HTS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2312
Mailing Address - Country:US
Mailing Address - Phone:210-567-8329
Mailing Address - Fax:210-567-8328
Practice Address - Street 1:8614 QUEEN HTS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2312
Practice Address - Country:US
Practice Address - Phone:210-567-8329
Practice Address - Fax:210-567-8328
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX360721835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy