Provider Demographics
NPI:1093871162
Name:BURNHAM, CHRISTALYN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTALYN
Middle Name:
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 ABRAMS RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5585
Mailing Address - Country:US
Mailing Address - Phone:972-699-0334
Mailing Address - Fax:
Practice Address - Street 1:12830 HILLCREST RD
Practice Address - Street 2:SUITE 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1527
Practice Address - Country:US
Practice Address - Phone:972-364-9024
Practice Address - Fax:972-364-9025
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor