Provider Demographics
NPI:1811182389
Name:ELVIRA C BURNS, MD PA
Entity type:Organization
Organization Name:ELVIRA C BURNS, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:CANALES
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-686-0133
Mailing Address - Street 1:2102 W TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5933
Mailing Address - Country:US
Mailing Address - Phone:432-686-0133
Mailing Address - Fax:432-686-0937
Practice Address - Street 1:2102 W TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5933
Practice Address - Country:US
Practice Address - Phone:432-686-0133
Practice Address - Fax:432-686-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0219261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE15759Medicare UPIN