Provider Demographics
NPI:1477516219
Name:BURLEY, RONNELLE SHERI (MD)
Entity Type:Individual
Prefix:
First Name:RONNELLE
Middle Name:SHERI
Last Name:BURLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1320
Mailing Address - Country:US
Mailing Address - Phone:806-722-1253
Mailing Address - Fax:806-722-0268
Practice Address - Street 1:3706 22ND PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1320
Practice Address - Country:US
Practice Address - Phone:806-722-1253
Practice Address - Fax:806-722-0268
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0340207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141110001Medicaid
TX8579M1Medicare ID - Type Unspecified