Individual
JOSEPH H BURKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2400
(817) 735-0615
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2400
(817) 735-0615
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
G9072
TX
2084P0800X
Psychiatry Physician
Primary
G9072
TX
2084P0804X
Child & Adolescent Psychiatry Physician
G9072
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117552301
—
TX
05
—
117552304
—
TX
05
—
117552305
—
TX
01
—
8CR417
BCBS
TX
01
—
P00998008
RAILROAD MEDICARE
TX
Enumeration date
12/05/2006
Last updated
01/03/2020
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