Healthcare Provider Details

I. General information

NPI: 1437205002
Provider Name (Legal Business Name): ROY NEAL BURK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E 8TH ST
LITTLEFIELD TX
79339-3821
US

IV. Provider business mailing address

PO BOX 750
LITTLEFIELD TX
79339-0750
US

V. Phone/Fax

Practice location:
  • Phone: 803-385-4435
  • Fax: 806-385-5414
Mailing address:
  • Phone: 806-385-4435
  • Fax: 806-385-5414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11558
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: