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Individual

DAMEIN M BURGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4522
Mailing address
8950 TAYLOR LN, SHREVEPORT, LA 71129-4353

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
113333
LA
367500000X
Certified Registered Nurse Anesthetist
776338
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
210778101
TX
05
210778102
TX
01
750818167015
TRICARE
TX
01
8953UU
BCBS OF TEXAS
TX
Enumeration date
01/28/2010
Last updated
03/18/2026
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