Individual
BETHANY KEARNS BURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
608 RADAM LN, AUSTIN, TX 78745-1172
(512) 443-5988
(512) 443-5055
Mailing address
8240 N MOPAC EXPY STE 100, AUSTIN, TX 78759-8869
(512) 687-1970
(512) 407-9010
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
125060265
IL
208800000X
Urology Physician
Primary
U1870
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036140193
STATE LICENSE
IL
01
—
U1870
TEXAS MEDICAL BOARD
TX
Enumeration date
03/21/2011
Last updated
10/17/2023
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