Individual provider · NPI-1

Dr. Selene Burke, OD

Optometrist · Irving, TX

NPI number1962827402
StatusActive
Last updated in NPPESMay 17, 2022

Details

NPI
1962827402
Entity type
Individual (NPI-1)
Name
Dr. Selene Burke
Credential
OD
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 20, 2014
Certification date
May 17, 2022
Last updated
May 17, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist06826TGTXYes
152W00000X Optometrist752MS
152W00000X Optometrist2702TN

Practice location

9155 Sterling St Ste 160
Irving, TX 75063-2430

Phone 972-896-1653

Mailing address

3425 Navarro Way
Frisco, TX 75034-2133

Phone 972-896-1653

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