Burton, Gabriel Thierry

Burton, Gabriel Thierry is an individual health care provider with primary practice located at 1 Childrens Pl Ste 3110, Saint Louis MO 63110-1002. He recently has only one registered license in Eye and Vision Services Providers / Pediatrics, which is considered as his primary health care specialty. Burton, Gabriel Thierry can be contacted via phone (314) 454-6026.

Contact Information

Primary practice address
1 Childrens Pl Ste 3110 Saint Louis MO 63110-1002
Phone: (314) 454-6026
Fax: (866) 936-4559
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Pediatrics 152WP0200X 2012024705 Missouri

Profile Details

NPI number 1114272200
LBN Legal business name Burton, Gabriel Thierry
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2012
Last updated Jun 20th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114272200 NPPES
Missouri MEDICAID 319876504

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