Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 6416 | TX |
N | 111NN1001X | Nutrition | 6416 | TX |
NPI | 1073562138 |
---|---|
Provider Name | Joseph Andrew Burt |
First Address | Mcallen, TX 78504-3004 |
Second Address | Mcallen, TX 78504-2610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 08/07/2007 |