Provider Demographics
NPI:1588901284
Name:BURBRIDGE, LLOYD THOMAS III
Entity type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:THOMAS
Last Name:BURBRIDGE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NORTH LOOP W STE 408
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1027
Mailing Address - Country:US
Mailing Address - Phone:713-623-6306
Mailing Address - Fax:713-623-0704
Practice Address - Street 1:2525 NORTH LOOP W STE 408
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1027
Practice Address - Country:US
Practice Address - Phone:713-623-6306
Practice Address - Fax:713-623-0704
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45-3969804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor