Provider Demographics
NPI:1396913745
Name:BURDICK, CHRISTOPHER JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:BURDICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPURS LN
Mailing Address - Street 2:STE 230B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1669
Mailing Address - Country:US
Mailing Address - Phone:210-690-7400
Mailing Address - Fax:210-690-7405
Practice Address - Street 1:21 SPURS LN
Practice Address - Street 2:STE 230B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1669
Practice Address - Country:US
Practice Address - Phone:210-690-7400
Practice Address - Fax:210-690-7405
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7081207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01337169OtherRAILROAD MEDICARE
TXP01266098OtherMEDICARE RAILROAD
TX301217102Medicaid
TX295552YP78Medicare PIN
TX301217102Medicaid