Individual
TRAVIS BURDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IRT
Contact information
Practice address
3005 SW 129TH ST, OKLAHOMA CITY, OK 73170-2019
(405) 831-6996
Mailing address
3005 SW 129TH ST, OKLAHOMA CITY, OK 73170-2019
(405) 831-6996
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
OK
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100685660A
—
OK
05
—
100685660D
—
OK
Enumeration date
05/03/2010
Last updated
03/11/2026
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