Provider Demographics
NPI:1467488502
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
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BURG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
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:77338-3522
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:77338-3522
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:2006-06-23
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184435901Medicaid
TX676650Medicare Oscar/Certification