Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | H7591 | TX |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | H7591 | TX |
NPI | 1306858295 |
---|---|
Provider Name | Ronald G Burke |
First Address | Fort Worth, TX 76199-0371 |
Second Address | Fort Worth, TX 76104-2710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 02/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00U87Z | BCBSTX GRP PIN (01) | TX |
10008081 | AMERIGROUP PIN (01) | TX |
124032 | SUPERIOR PIN (01) | TX |
133133100 | FIRSTCARE PIN (01) | TX |
137345810 | (05) | TX |
140442852 | (05) | TX |
155848803 | (05) | TX |
155848804 | CSHCN (01) | TX |
1850793 | FIRSTHEALTH PIN (01) | TX |
2278186 | UHC PIN (01) | TX |
4201830 | CIGNA PIN (01) | TX |
7424364 | AETNA PIN (01) | TX |
8G3391 | BCBSTX IND PIN (01) | TX |
G10692 | (02) |