Provider Demographics
NPI:1992923049
Name:BURR, NAOMI LYNNEA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:LYNNEA
Last Name:BURR
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:ROGER
Other - Middle Name:KENTON
Other - Last Name:BURR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:730 ISOM RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4026
Mailing Address - Country:US
Mailing Address - Phone:833-937-5463
Mailing Address - Fax:
Practice Address - Street 1:KIND CLINIC
Practice Address - Street 2:730 ISOM RD
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216
Practice Address - Country:US
Practice Address - Phone:833-937-5463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10313207Q00000X
TXH6084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138520513OtherTEXAS PROVIDER IDENTIFIER (TPI)
TX8379N0Medicare PIN
TX138520513OtherTEXAS PROVIDER IDENTIFIER (TPI)