Provider Demographics
NPI:1396891172
Name:BURKI, MASOODA M (MD)
Entity type:Individual
Prefix:DR
First Name:MASOODA
Middle Name:M
Last Name:BURKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MASOODA
Other - Middle Name:
Other - Last Name:MUKHTAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1602 SW 82ND STREET
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505
Mailing Address - Country:US
Mailing Address - Phone:580-536-0077
Mailing Address - Fax:580-510-2869
Practice Address - Street 1:1602 SW 82ND STREET
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505
Practice Address - Country:US
Practice Address - Phone:580-536-0077
Practice Address - Fax:580-510-2869
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010478742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry