MEDICARE: COREY ANTONIO BURNEY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1306990	TX

General Provider Information

NPI Number	:	1811488950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY ANTONIO BURNEY DPT

Provider Business Mailing Address
First Line	:	3824 S CARRIER PKWY STE 490
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-6668
Country	:	US
Telephone Number	:	817-984-3260
Fax Number	:	817-420-6029

Provider Business Practice Location Address
First Line	:	6116 LAKE WORTH BLVD STE 100
Second Line	:
City	:	LAKE WORTH
State	:	TX
Zip	:	76135-3707
Country	:	US
Telephone Number	:	817-984-3260
Fax Number	:	817-420-6029

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	10/27/2025

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Directions to “ COREY ANTONIO BURNEY DPT” Practice Location

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