Provider Demographics
NPI:1366670242
Name:LINDA L BURK MD
Entity Type:Organization
Organization Name:LINDA L BURK MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-987-2875
Mailing Address - Street 1:1703 N BECKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1007
Mailing Address - Country:US
Mailing Address - Phone:214-987-2875
Mailing Address - Fax:214-946-9877
Practice Address - Street 1:1703 N BECKLEY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203
Practice Address - Country:US
Practice Address - Phone:214-987-2875
Practice Address - Fax:214-946-9877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2998207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114143401Medicaid
TXC13943Medicare UPIN
TX114143401Medicaid