Individual
MATTHEW BURRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5012 S US HIGHWAY 75 STE 105, DENISON, TX 75020-4611
(903) 416-6490
(903) 463-1201
Mailing address
5012 S US HIGHWAY 75 STE 300, ATTN BILLING, DENISON, TX 75020-4589
(903) 416-6490
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2014-01688
NC
208600000X
Surgery Physician
Primary
R0844
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518194984
—
NC
01
—
19CQ8
BCBS NC
NC
05
—
3740391-01
—
TX
Enumeration date
06/12/2009
Last updated
07/08/2021
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