Basic Information
Provider Information
NPI: 1356888325
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURNS
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 4897
Address2:  
City: HOUSTON
State: TX
PostalCode: 772104897
CountryCode: US
TelephoneNumber: 8889911101
FaxNumber: 9037875854
Practice Location
Address1: 1501 E MOCKINGBIRD LN STE 101
Address2:  
City: VICTORIA
State: TX
PostalCode: 779042178
CountryCode: US
TelephoneNumber: 3615736291
FaxNumber: 3615762434
Other Information
ProviderEnumerationDate: 01/27/2017
LastUpdateDate: 10/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X814621TXN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XAP133169TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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