Provider Demographics
NPI:1841396017
Name:BURNS, CHRISTOPHER RYAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:BURNS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 HOLLYBROOK DR STE 3401
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2412
Mailing Address - Country:US
Mailing Address - Phone:903-753-3331
Mailing Address - Fax:903-247-0643
Practice Address - Street 1:709 HOLLYBROOK DR STE 3401
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2412
Practice Address - Country:US
Practice Address - Phone:903-753-3331
Practice Address - Fax:903-247-0643
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.A10546.RX363AM0700X
TXPA06775363A00000X
TXPA TEMP363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1453030Medicaid
TX211971103Medicaid
LA1453030Medicaid