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General NPI Number Information
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NPI Number | 1649369463
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Entity Type | Individual
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Provider Name | BURKE DAVID MARTIN OD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 02/17/2014
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Provider Practice Location Address
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Address Line | 2701 S I H 35
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City | ROUND ROCK
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State | TX
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Zip | 78664-7320
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Country | US
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Telephone | 512-388-2600
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Fax | 512-388-0854
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Provider Business Mailing Address
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Address Line | 1308 ARRONIMINK CIR
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City | AUSTIN
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State | TX
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Zip | 78746-6303
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Country | US
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Telephone | 512-785-0632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5141T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT001505
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 5141T
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPT001505
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License Number State | GA
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