Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | E2152 | TX |
N | 208600000X | Surgeon | E2152 | TX |
N | 2086S0129X | Vascular Surgeon | E2152 | TX |
NPI | 1003817768 |
---|---|
Provider Name | Dr. Gail E Burbridge JR. |
First Address | Houston, TX 77004-6900 |
Second Address | Houston, TX 77004-6900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B21584 | (02) | TX |