Provider Demographics
NPI:1407030281
Name:BURDIN HEALTHCARE HOLDINGS, LLC
Entity Type:Organization
Organization Name:BURDIN HEALTHCARE HOLDINGS, LLC
Other - Org Name:BURDIN CHIROPRACTIC NEUROLOGY & REHAB GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:BURDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:210-690-6992
Mailing Address - Street 1:9502 COMPUTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2382
Mailing Address - Country:US
Mailing Address - Phone:210-690-6992
Mailing Address - Fax:210-690-6952
Practice Address - Street 1:9502 COMPUTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2382
Practice Address - Country:US
Practice Address - Phone:210-690-6992
Practice Address - Fax:210-690-6952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS067471041C0700X
TXDC6933111NN0400X
TX109851225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU59688Medicare UPIN
TXS32811Medicare UPIN