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Individual
SCOTT BRADLEY BURRIS
Active
Individual
SCOTT BRADLEY BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G9406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050065934
RAILROAD
TX
05
—
128023203
—
TX
05
—
128023206
—
TX
05
—
128023207
—
TX
01
—
128023208
MEDICAID CSHCN
TX
01
—
83852K
BCBS
TX
Enumeration date
12/22/2005
Last updated
09/20/2013
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