Basic Information
| Provider Information | |||||||||
| NPI: | 1992923049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURR | ||||||||
| FirstName: | NAOMI | ||||||||
| MiddleName: | LYNNEA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, MPH | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BURR | ||||||||
| OtherFirstName: | ROGER | ||||||||
| OtherMiddleName: | KENTON | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD, MPH | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 310 W OAKLAWN RD | ||||||||
| Address2: | |||||||||
| City: | PLEASANTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780644033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8305698940 | ||||||||
| FaxNumber: | 8302246905 | ||||||||
| Practice Location | |||||||||
| Address1: | 19010 PREIST BLVD | ||||||||
| Address2: | |||||||||
| City: | LYTLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780523486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8307729865 | ||||||||
| FaxNumber: | 8307729821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 01/28/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD-10313 | HI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | H6084 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.