Provider Demographics
NPI:1861913238
Name:ADVANCED ENDOSCOPY CONSULTANTS PLLC
Entity type:Organization
Organization Name:ADVANCED ENDOSCOPY CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:BURDICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-884-4030
Mailing Address - Street 1:PO BOX 674431
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4431
Mailing Address - Country:US
Mailing Address - Phone:972-616-4000
Mailing Address - Fax:
Practice Address - Street 1:6500 SIERRA DR # 170
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2480
Practice Address - Country:US
Practice Address - Phone:972-884-4030
Practice Address - Fax:972-884-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty