Provider Demographics
NPI:1629289897
Name:BURNS, TIFFANY CARO (MD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:CARO
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 691087
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1087
Mailing Address - Country:US
Mailing Address - Phone:281-970-8899
Mailing Address - Fax:281-970-8892
Practice Address - Street 1:18220 STATE HIGHWAY 249
Practice Address - Street 2:SUITE 390
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-970-8899
Practice Address - Fax:281-970-8892
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1629289897OtherBLUE CROSS BLUE SHIELD
TXP00963008OtherRR MEDICARE
TX191251102Medicaid
TX191521103Medicaid
TX8CG377OtherBLUE CROSS BLUE SHIELD
TXP01312374OtherRR MEDICARE
TX191521103Medicaid
TX8CG377OtherBLUE CROSS BLUE SHIELD
TXP01312374OtherRR MEDICARE
TXP00963008OtherRR MEDICARE
TX332801YMVQMedicare PIN