Provider Demographics
NPI:1053702092
Name:BURTON HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:BURTON HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:979-732-3900
Mailing Address - Street 1:2126 S. STATE HWY 71
Mailing Address - Street 2:STE. C
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934
Mailing Address - Country:US
Mailing Address - Phone:979-966-3271
Mailing Address - Fax:979-732-3907
Practice Address - Street 1:2126 S. STATE HWY 71
Practice Address - Street 2:STE. C
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934
Practice Address - Country:US
Practice Address - Phone:979-966-3271
Practice Address - Fax:979-732-3907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB147420Medicare PIN