Provider Demographics
NPI:1841473345
Name:BILL BURKE, DO A PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:BILL BURKE, DO A PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH 'BILL'
Authorized Official - Middle Name:W
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:817-431-2573
Mailing Address - Street 1:808 KELLER PKWY
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2405
Mailing Address - Country:US
Mailing Address - Phone:817-431-2573
Mailing Address - Fax:817-379-6881
Practice Address - Street 1:808 KELLER PKWY
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2405
Practice Address - Country:US
Practice Address - Phone:817-431-2573
Practice Address - Fax:817-379-6881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00945VMedicare PIN