Individual
MR. CARL A BURDEX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8220 CRESTLINE CT, OKLAHOMA CITY, OK 73132-1321
(405) 721-2687
Mailing address
8220 CRESTLINE CT, OKLAHOMA CITY, OK 73132-1321
(405) 721-2687
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200123000A
—
OK
Enumeration date
03/24/2010
Last updated
03/24/2010
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