Provider Demographics
NPI:1467858340
Name:BURKS, VALERIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALERIA
Middle Name:
Last Name:BURKS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3013
Mailing Address - Country:US
Mailing Address - Phone:903-792-8351
Mailing Address - Fax:903-794-0847
Practice Address - Street 1:4222 TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3013
Practice Address - Country:US
Practice Address - Phone:903-792-8351
Practice Address - Fax:903-794-0847
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29496122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist