Individual
SCOTT ALAN BURLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 939-7723
Mailing address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 939-7723
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
M7884
TX
208VP0000X
Pain Medicine Physician
Primary
M7884
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1953411601
—
TX
05
—
195341602
—
TX
01
—
8U8518
BCBS OF TEXAS
TX
01
—
TIN PLUS 042
TRICARE
TX
Enumeration date
06/14/2007
Last updated
10/18/2022
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