Provider Demographics
NPI:1962589515
Name:BURGMAN, JULIE ANN (PA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:BURGMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:SUITE 143
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-467-8491
Mailing Address - Fax:713-461-6118
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 143
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-467-8491
Practice Address - Fax:713-461-6118
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10101363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant