Provider Demographics
NPI:1447331335
Name:BURKE, SHERRI A (DO)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:3200 RIVERFRONT DR
Practice Address - Street 2:STE103
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6570
Practice Address - Country:US
Practice Address - Phone:817-336-3800
Practice Address - Fax:817-335-9454
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8994208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2110723OtherFIRSTHEALTH PIN
TXBURSF34697OtherCCHIP PIN
TX102244406Medicaid
TX135879100OtherFIRSTCARE PIN
TX4235136OtherAETNA PIN
TX5558301OtherCIGNA PIN
TX1014718OtherUHC PIN
1750369203OtherGRP NPI NUMBER
TX8G0312OtherBCBSTX IND PIN
TX00U87ZOtherBCBSTX GRP PIN
TX102244407OtherCSHCN
TX2110723OtherFIRSTHEALTH PIN
F34697Medicare UPIN