Provider Demographics
NPI:1598296931
Name:BURGESS, THOMAS DAVID (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DAVID
Last Name:BURGESS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 BELLAIRE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4515
Mailing Address - Country:US
Mailing Address - Phone:713-622-1700
Mailing Address - Fax:713-877-0672
Practice Address - Street 1:4747 BELLAIRE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4515
Practice Address - Country:US
Practice Address - Phone:713-622-1700
Practice Address - Fax:713-877-0672
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT5835207L00000X, 208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine