Provider Demographics
NPI:1689123358
Name:BURNS, SHELIA (CPT)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8243 SUETELLE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-9247
Mailing Address - Country:US
Mailing Address - Phone:214-281-6115
Mailing Address - Fax:469-779-9438
Practice Address - Street 1:8243 SUETELLE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-9247
Practice Address - Country:US
Practice Address - Phone:214-281-6115
Practice Address - Fax:469-779-9438
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAP4K5A2K8246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy