Provider Demographics
NPI:1396773651
Name:BURLEIGH, LARRY M (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:M
Last Name:BURLEIGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:LARRY
Other - Middle Name:M
Other - Last Name:BURLEIGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:7825 HIGHWAY 6 N STE 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1705
Mailing Address - Country:US
Mailing Address - Phone:832-237-3331
Mailing Address - Fax:832-237-4638
Practice Address - Street 1:7825 HIGHWAY 6 N STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1705
Practice Address - Country:US
Practice Address - Phone:832-237-3331
Practice Address - Fax:832-237-4638
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87K951OtherBCBS
TXU18602OtherUPIN
TX87K951Medicare ID - Type Unspecified
TX454874Medicare Oscar/Certification
TXU18602Medicare UPIN