Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | L9638 | TX |
NPI | 1003029828 |
---|---|
Provider Name | Michael W Burris |
First Address | Austin, TX 78758-5354 |
Second Address | Austin, TX 78758-5354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 06/03/2012 |