Basic Information
| Provider Information | |||||||||
| NPI: | 1184600397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NELON | ||||||||
| FirstName: | BURLYN | ||||||||
| MiddleName: | CRAIG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 434 SW WILSHIRE BLVD | ||||||||
| Address2: | |||||||||
| City: | BURLESON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760285330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174471208 | ||||||||
| FaxNumber: | 8174471106 | ||||||||
| Practice Location | |||||||||
| Address1: | 434 SW WILSHIRE BLVD | ||||||||
| Address2: | |||||||||
| City: | BURLESON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760285330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174471208 | ||||||||
| FaxNumber: | 8174471106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2005 | ||||||||
| LastUpdateDate: | 11/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G3640 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.