Healthcare Provider Details

I. General information

NPI: 1245671064
Provider Name (Legal Business Name): SARA S BURKE, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 TRAVIS ST SUITE 210
DALLAS TX
75204-1448
US

IV. Provider business mailing address

3535 TRAVIS ST SUITE 210
DALLAS TX
75204-1448
US

V. Phone/Fax

Practice location:
  • Phone: 214-522-0210
  • Fax: 214-522-0474
Mailing address:
  • Phone: 214-522-0210
  • Fax: 214-522-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG3199
License Number StateTX

VIII. Authorized Official

Name: DR. SARA S BURKE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 214-522-0210