Provider Demographics
NPI:1952303299
Name:BURNS, CARRIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4308 ALLENBROOK DRIVE
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521
Mailing Address - Country:US
Mailing Address - Phone:281-422-4141
Mailing Address - Fax:281-422-5939
Practice Address - Street 1:4308 ALLENBROOK DRIVE
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521
Practice Address - Country:US
Practice Address - Phone:281-422-4141
Practice Address - Fax:281-422-5939
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W939Medicare UPIN