Individual
CHRISTINE RENEE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3445 EXECUTIVE CENTER DRIVE, STE 250, AUSTIN, TX 78731-1678
(512) 579-4000
(512) 439-2814
Mailing address
3445 EXECUTIVE CENTER DRIVE, STE 250, AUSTIN, TX 78731-1678
(512) 579-4000
(512) 439-2814
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
054758
GA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
M7343
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189996501
—
TX
01
—
189996502
CSHCN
TX
05
—
189996503
—
TX
01
—
8AN450
BCBSTX
TX
Enumeration date
04/12/2007
Last updated
02/02/2022
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