Provider Demographics
NPI:1578117131
Name:BURNETTE, SETH T (PA-C)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:T
Last Name:BURNETTE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21216 NORTHWEST FWY STE 670
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4697
Mailing Address - Country:US
Mailing Address - Phone:281-970-6500
Mailing Address - Fax:281-970-6510
Practice Address - Street 1:21216 NORTHWEST FWY STE 670
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4697
Practice Address - Country:US
Practice Address - Phone:281-970-6500
Practice Address - Fax:281-970-6510
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYPA2534363AS0400X
TXPA14884363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical