Provider Demographics
NPI:1801033725
Name:BURKET, GAYLAN (OTR)
Entity Type:Individual
Prefix:
First Name:GAYLAN
Middle Name:
Last Name:BURKET
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 SUNDEW CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7222
Mailing Address - Country:US
Mailing Address - Phone:972-964-3072
Mailing Address - Fax:
Practice Address - Street 1:3901 SUNDEW CT
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7222
Practice Address - Country:US
Practice Address - Phone:972-964-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109522225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist