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Organization
TOM C. BURDITT, JR.
Active
Organization
TOM C. BURDITT, JR.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM CONNOLLY BURDITT JR. LCSW (SOLE PROPRIETOR)
(512) 322-0209
Entity
Organization
Contact information
Practice address
2630 EXPOSITION BLVD STE 116, AUSTIN, TX 78703-1758
(512) 322-0209
Mailing address
2630 EXPOSITION BLVD STE 116, AUSTIN, TX 78703-1758
(512) 322-0209
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000209
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00S70B
BLUE CROSS
TX
Enumeration date
10/06/2006
Last updated
06/09/2008
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