Provider Demographics
NPI:1881680338
Name:BURNS, WILLIAM E JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 OAK DR S STE 203
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5627
Mailing Address - Country:US
Mailing Address - Phone:979-297-4507
Mailing Address - Fax:979-480-9074
Practice Address - Street 1:201 OAK DR S
Practice Address - Street 2:STE 101
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5626
Practice Address - Country:US
Practice Address - Phone:979-297-4507
Practice Address - Fax:979-480-9074
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6265207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00KE01Medicare ID - Type Unspecified