Provider Demographics
NPI:1760582688
Name:BURTON, ALLEN W (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:W
Last Name:BURTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 MAIN ST
Mailing Address - Street 2:#400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4456
Mailing Address - Country:US
Mailing Address - Phone:832-553-1336
Mailing Address - Fax:832-553-1337
Practice Address - Street 1:7700 MAIN ST # 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4456
Practice Address - Country:US
Practice Address - Phone:832-553-1336
Practice Address - Fax:832-553-1337
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7922207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF61530Medicare UPIN