Provider Demographics
NPI:1669443289
Name:BURHANS, HARLAN V (DC)
Entity Type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:V
Last Name:BURHANS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-1605
Mailing Address - Country:US
Mailing Address - Phone:361-777-2838
Mailing Address - Fax:361-814-1875
Practice Address - Street 1:537 MOORE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TX
Practice Address - Zip Code:78374-1605
Practice Address - Country:US
Practice Address - Phone:361-777-2838
Practice Address - Fax:361-814-1875
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147116101Medicaid
TXU79224Medicare UPIN
TX147116101Medicaid