Provider Demographics
NPI:1962477091
Name:JOHN L. BURNS, M.D., P.A.
Entity Type:Organization
Organization Name:JOHN L. BURNS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:G
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-456-8834
Mailing Address - Street 1:PO BOX 35046
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0046
Mailing Address - Country:US
Mailing Address - Phone:214-456-8834
Mailing Address - Fax:214-456-6843
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:#6000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-456-8834
Practice Address - Fax:214-456-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL63062086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00145XMedicare ID - Type Unspecified
TXI11020Medicare UPIN