Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 13680 | TX |
NPI | 1952885667 |
---|---|
Provider Name | Dr. Steven Ross Burr |
First Address | Mesquite, TX 75149-4663 |
Second Address | Mesquite, TX 75149-4663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 18/09/2018 |