Healthcare Provider Details

I. General information

NPI: 1487082137
Provider Name (Legal Business Name): SCOTT BURKHART PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 PRESTON RD STE 1200
PLANO TX
75024
US

IV. Provider business mailing address

7211 PRESTON RD STE 1200
PLANO TX
75024-0238
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-9250
  • Fax:
Mailing address:
  • Phone: 214-456-9250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number37743
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: