Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1155540 | TX |
NPI | 1053693994 |
---|---|
Provider Name | Mrs. Renallie R Burns |
First Address | Mckinney, TX 75070-8169 |
Second Address | Mckinney, TX 75071-8306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2011 |
Last Update Date | 18/09/2013 |