Provider Demographics
NPI:1023637360
Name:BURCHAM, AMY LEIGHANN (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LEIGHANN
Last Name:BURCHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:LEIGHANN
Other - Last Name:BADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8220 WALNUT HILL LN STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4403
Mailing Address - Country:US
Mailing Address - Phone:214-691-8000
Mailing Address - Fax:
Practice Address - Street 1:1801 VALLEY VIEW LN
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-8906
Practice Address - Country:US
Practice Address - Phone:214-420-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3054152W00000X
TX10005152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist