Individual
LISA BURR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2811 E 2ND ST, AUSTIN, TX 78702-4843
(512) 324-4930
(512) 324-2929
Mailing address
3706 S 1ST ST, AUSTIN, TX 78704-7046
(512) 324-4973
(512) 324-4948
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
542364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111433201
MEDICAID EPSDT
TX
05
—
148555901
—
TX
Enumeration date
08/10/2006
Last updated
07/08/2007
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