Individual
MARY LOUISE BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4503 MONARCH BLUE LN, FRESNO, TX 77545-7195
(281) 684-3472
Mailing address
4503 MONARCH BLUE LN, FRESNO, TX 77545-7195
(281) 684-3472
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41572936
DRIVERS LICENSE
TX
Enumeration date
06/20/2022
Last updated
06/20/2022
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