Provider Demographics
NPI:1003830506
Name:BURKE, ROBERT ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARTHUR
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 OAKMONT BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3900
Mailing Address - Country:US
Mailing Address - Phone:817-423-0600
Mailing Address - Fax:
Practice Address - Street 1:7100 OAKMONT BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3900
Practice Address - Country:US
Practice Address - Phone:817-423-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5716207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122038604Medicaid
TX00046JOtherBLUE CROSS BLUE SHIELD PR
TX10028422OtherAMERIGROUP
TX00046JOtherBLUE CROSS BLUE SHIELD PR
TX00046JMedicare PIN