Healthcare Provider Details

I. General information

NPI: 1427055391
Provider Name (Legal Business Name): DANTE R BURGOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4324 MAPLESHADE LN STE 158
PLANO TX
75093-0050
US

IV. Provider business mailing address

PO BOX 2022
ALLEN TX
75013-0035
US

V. Phone/Fax

Practice location:
  • Phone: 903-274-7553
  • Fax:
Mailing address:
  • Phone: 972-712-0591
  • Fax: 972-421-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberH8595
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH8595
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: