Provider Demographics
NPI:1154346989
Name:BURGHER, BALLARD M III (PHD)
Entity type:Individual
Prefix:DR
First Name:BALLARD
Middle Name:M
Last Name:BURGHER
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:3701 KIRBY DR
Mailing Address - Street 2:STE 890
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3918
Mailing Address - Country:US
Mailing Address - Phone:713-397-3859
Mailing Address - Fax:713-838-8633
Practice Address - Street 1:3701 KIRBY DR
Practice Address - Street 2:STE 890
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3918
Practice Address - Country:US
Practice Address - Phone:713-397-3859
Practice Address - Fax:713-838-8633
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2019-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX30779103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040338808Medicaid
TX040338808Medicaid