Provider Demographics
NPI:1700094984
Name:VERA-BURKHALTER, CHERYL DALYNDA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:DALYNDA
Last Name:VERA-BURKHALTER
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 1:3000 BLACKBURN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2217
Mailing Address - Country:US
Mailing Address - Phone:214-599-8624
Mailing Address - Fax:214-559-9156
Practice Address - Street 1:3000 BLACKBURN ST STE 130
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2217
Practice Address - Country:US
Practice Address - Phone:214-599-8624
Practice Address - Fax:214-559-9156
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DY697OtherBLUE CROSS
TX189457806Medicaid
TX189457807Medicaid
TX189457806Medicaid
TX285508YK5BMedicare PIN