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Organization

THOMAS K BURDENSKI PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS KEVIN BURDENSKI PHD (OWNER)
(817) 390-0453
Entity
Organization

Contact information

Practice address
6777 CAMP BOWIE BLVD STE 321, FORT WORTH, TX 76116-7178
(817) 390-0453
Mailing address
1532 VERNON CASTLE AVE, BENBROOK, TX 76126-4291
(817) 390-0453

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
33118
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1497939318
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
07/21/2017
Last updated
07/21/2017
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