Provider Demographics
NPI:1417990144
Name:CHRIS BURLING, M.D., P.A.
Entity Type:Organization
Organization Name:CHRIS BURLING, M.D., P.A.
Other - Org Name:MT. PLEASANT FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BURLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-575-9500
Mailing Address - Street 1:618 N JEFFERSON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-3647
Mailing Address - Country:US
Mailing Address - Phone:903-575-9500
Mailing Address - Fax:903-575-9866
Practice Address - Street 1:618 N JEFFERSON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-3647
Practice Address - Country:US
Practice Address - Phone:903-575-9500
Practice Address - Fax:903-575-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7676207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181903901Medicaid
TX00W607Medicare PIN