Organization
HOUSTON INFECTIOUS DISEASE ASSOCIATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN J. BURGERT M.D. (OWNER)
(713) 791-4882
Entity
Organization
Contact information
Practice address
6624 FANNIN ST, SUITE 1410, HOUSTON, TX 77030-2312
(713) 791-4882
(713) 791-4159
Mailing address
6624 FANNIN ST, SUITE 1410, HOUSTON, TX 77030-2312
(713) 791-4882
(713) 791-4159
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
H9045
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QW03
BLUE CROSS
TX
05
—
084604001
—
TX
01
—
CS4960
MEDICARE RR
TX
Enumeration date
01/26/2007
Last updated
04/06/2009
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