Healthcare Provider Details

I. General information

NPI: 1548310147
Provider Name (Legal Business Name): BURKE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S MEDFORD DR
LUFKIN TX
75901-6260
US

IV. Provider business mailing address

2001 S MEDFORD DR
LUFKIN TX
75901-6260
US

V. Phone/Fax

Practice location:
  • Phone: 936-633-5676
  • Fax: 936-633-5695
Mailing address:
  • Phone: 936-633-5676
  • Fax: 936-633-5695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: PATSY DUNKS
Title or Position: DIRECTOR BILLING DEPARTMENT
Credential:
Phone: 936-633-5676