Provider Demographics
NPI:1356695290
Name:MOUNT PLEASANT PHYSICIANS,PLLC
Entity type:Organization
Organization Name:MOUNT PLEASANT PHYSICIANS,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAMS
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-717-8705
Mailing Address - Street 1:202 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2320
Mailing Address - Country:US
Mailing Address - Phone:903-717-8705
Mailing Address - Fax:
Practice Address - Street 1:202 W 19TH ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2320
Practice Address - Country:US
Practice Address - Phone:903-717-8705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9637207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty