Basic Information
| Provider Information | |||||||||
| NPI: | 1841475415 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BURLESON FAMILY MEDICAL CENTER, P.A. | ||||||||
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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: | 01/02/2008 | ||||||||
| LastUpdateDate: | 03/26/2010 | ||||||||
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| AuthorizedOfficialLastName: | BARFIELD | ||||||||
| AuthorizedOfficialFirstName: | M | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8174471208 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.