Individual
LACY D BURKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
205 W TYLER ST, CANTON, TX 75103-1352
(903) 567-5437
(844) 678-6258
Mailing address
4922 SPRING AVENUE, DALLAS, TX 75210-1359
(469) 488-4700
(469) 488-4701
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
754047
TX
Other
Enumeration date
07/10/2012
Last updated
01/28/2020
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