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Organization
THIRD COAST EMERGENCY PHYSICIANS BURNET PA
Active
Organization
THIRD COAST EMERGENCY PHYSICIANS BURNET PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM ROBERTS MD (PRESIDENT)
(512) 452-8533
Entity
Organization
Contact information
Practice address
3201 S HIGHWAY 281, BURNET, TX 78611-4510
(512) 756-6000
Mailing address
6300 LA CALMA DR, SUITE 200, AUSTIN, TX 78752-3843
(512) 452-8533
(512) 452-9306
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015DQ
BCBS
TX
01
—
0083QQ
BCBS
TX
05
—
079914004
—
TX
01
—
079914005
CSHCN
TX
Enumeration date
06/04/2006
Last updated
06/16/2009
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