Provider Demographics
NPI:1972633196
Name:BURKE, DENNIS BRUCE (RPH)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:BRUCE
Last Name:BURKE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 N. MACARTHUR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2848
Mailing Address - Country:US
Mailing Address - Phone:972-580-1814
Mailing Address - Fax:972-650-1072
Practice Address - Street 1:6420 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2837
Practice Address - Country:US
Practice Address - Phone:972-580-1814
Practice Address - Fax:972-650-1072
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist