Provider Demographics
NPI:1407166291
Name:JAMES BURKHOLDER/ MONICA RAMOS D.D.S
Entity Type:Organization
Organization Name:JAMES BURKHOLDER/ MONICA RAMOS D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BURKHOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-428-5566
Mailing Address - Street 1:1122 E TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7138
Mailing Address - Country:US
Mailing Address - Phone:956-428-5566
Mailing Address - Fax:956-423-5818
Practice Address - Street 1:1122 E TYLER AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7138
Practice Address - Country:US
Practice Address - Phone:956-428-5566
Practice Address - Fax:956-423-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1821229311OtherNATIONAL PROVIDER IDENTIFIER
TX1437125747OtherNATIONAL PROVIDER IDENTIFIER