Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | N7062 | TX |
NPI | 1134474380 |
---|---|
Provider Name | Dr. Henry Leroy Burkholder IV |
First Address | Houston, TX 77024-2314 |
Second Address | Houston, TX 77024-2314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2012 |
Last Update Date | 08/11/2021 |