Provider Demographics
NPI:1477871333
Name:WHITFIELD VAN BUREN, KRISTIN LYNETTE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYNETTE
Last Name:WHITFIELD VAN BUREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6621 FANNIN ST
Mailing Address - Street 2:CC 1010.00
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-822-3131
Mailing Address - Fax:832-825-3633
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:CC 1010.00
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-822-3131
Practice Address - Fax:832-825-3633
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439542208000000X, 2080P0206X
TXM69532080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics