1154302511 NPI number — KAREN BURKE CRNA

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	BURKE
Provider First Name	:	KAREN
Provider Middle Name	:
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Provider Credential Text	:	CRNA
Provider Gender Code	:	F

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NPI Number	:	1154302511
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	04/11/2008
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Provider First Line Business Mailing Address	:	17207 KUYKENDAHL RD
Provider Second Line Business Mailing Address	:	#200
Provider Business Mailing Address City Name	:	SPRING
Provider Business Mailing Address State Name	:	TX
Provider Business Mailing Address Postal Code	:	773798423
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	8326985320
Provider Business Mailing Address Fax Number	:	8326985321

Provider First Line Business Practice Location Address	:	17207 KUYKENDAHL RD
Provider Second Line Business Practice Location Address	:	#200
Provider Business Practice Location Address City Name	:	SPRING
Provider Business Practice Location Address State Name	:	TX
Provider Business Practice Location Address Postal Code	:	773798423
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	8326985320
Provider Business Practice Location Address Fax Number	:	8326985321
Provider Enumeration Date	:	11/10/2005

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• Taxonomy code: 367500000X , with the licence number:  458932 , registered in the state of TX .