Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | D6725 | TX |
NPI | 1023078268 |
---|---|
Provider Name | Dr. Arthur Price Burdine |
First Address | San Angelo, TX 76904-7610 |
Second Address | San Angelo, TX 76904-6884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
821772 | BLUE CROSS (01) | TX |
C13932 | (02) | TX |