Provider Demographics
NPI:1982604526
Name:BURNS, STEPHEN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JAMES
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 LAMAR AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-5267
Mailing Address - Country:US
Mailing Address - Phone:903-739-9788
Mailing Address - Fax:903-739-9798
Practice Address - Street 1:3737 LAMAR AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-5267
Practice Address - Country:US
Practice Address - Phone:903-739-9788
Practice Address - Fax:903-739-9798
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098241501Medicaid
00F21MMedicare ID - Type Unspecified
TX098241501Medicaid