Provider Demographics
NPI:1992781140
Name:VANBURKLEO, WILLIAM B (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:VANBURKLEO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:VANBURKLEO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 181199
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78480-1199
Mailing Address - Country:US
Mailing Address - Phone:361-937-3303
Mailing Address - Fax:
Practice Address - Street 1:3242 NASSAU DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-2925
Practice Address - Country:US
Practice Address - Phone:361-937-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2040207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE45340Medicare UPIN
OKV002001003Medicare ID - Type Unspecified