Provider Demographics
NPI:1861520405
Name:BURK, JAMES L (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:BURK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15307 FM 1825 STE 4
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3174
Mailing Address - Country:US
Mailing Address - Phone:512-989-0888
Mailing Address - Fax:512-989-2728
Practice Address - Street 1:15307 FM 1825 STE 4
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3174
Practice Address - Country:US
Practice Address - Phone:512-989-0888
Practice Address - Fax:512-989-2728
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice