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Organization
BRAVURA FOOT AND ANKLE SPECIALISTS, PLLC
Active
Organization
BRAVURA FOOT AND ANKLE SPECIALISTS, PLLC
Active
Other names
Bravura FAS
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK WYLIE BURGE DPM (OWNER)
(214) 321-9410
Entity
Organization
Contact information
Practice address
1130 BEACHVIEW ST STE 200, DALLAS, TX 75218-3705
(214) 321-9410
Mailing address
PO BOX 180221, DALLAS, TX 75218-0221
(214) 321-9410
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
10/30/2020
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