Individual
JOHN D BURGOYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12201 RENFERT WAY, AUSTIN, TX 78758-5354
(512) 277-7500
(972) 984-1376
Mailing address
12201 RENFERT WAY, AUSTIN, TX 78758-5354
(512) 277-7500
(972) 984-1376
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00034623
WA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
MD00034623
WA
2086S0122X
Plastic and Reconstructive Surgery Physician
MD00034623
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8206468
—
WA
01
—
BU5281
REGENCE
WA
Enumeration date
05/03/2006
Last updated
05/15/2023
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