Provider Demographics
NPI:1831203462
Name:BURKS, ROBIN JOY (PHD)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:JOY
Last Name:BURKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 ECHO LN STE 335
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2750
Mailing Address - Country:US
Mailing Address - Phone:713-465-8560
Mailing Address - Fax:713-468-2868
Practice Address - Street 1:950 ECHO LN STE 335
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2750
Practice Address - Country:US
Practice Address - Phone:713-465-8560
Practice Address - Fax:713-468-2868
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23599103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0321853-01Medicaid
TX0321853-01Medicaid
00B94AMedicare UPIN