Individual
SCOTT BRADLEY BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13737 NOEL ROAD, SUITE 1400, DALLAS, TX 75240-2004
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5007
(972) 715-5682
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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