Individual provider Active NPI

Dalton Stryker Bourke, MD

  • Child & Adolescent Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1134623804
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
73098 Issued in WI
Practice address
1100 Wilford Hall Loop BLDG 4554
San Antonio, TX 78236-5638
Phone
(210) 292-6255
Fax
(210) 292-7934
NPI assigned
Mar 19, 2018
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 73098 WI
Psychiatry Physician 2084P0800X 2026-04445 NC
Child & Adolescent Psychiatry Physician 2084P0804X 73098 WI Primary

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
San Antonio, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
San Antonio, TX 78236-5638
Phone (210) 292-6255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MA, VA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20260407000196 WI Practitioner - Psychiatry 6406104611 Reassigns benefits to 1 organization
I20260612003539 MA Practitioner - Psychiatry 6406104611 Reassigns benefits to 1 organization
I20260617003317 VA Practitioner - Psychiatry 6406104611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Creighton University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1717 Main St
Suite 5850
Dallas, TX 75201-4681

1717 Main St
Suite 5850
Dallas, TX 75201-7317

18111 La Cantera Ter
Apt 8107
San Antonio, TX 78256-2674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73098WIMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whasc CurrentSince Oct 5, 2025 Accepting new patients

Locations

1100 Wilford Hall Loop
Bldg 4554
San Antonio, TX 78236
Phone (210) 292-6225

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1134623804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6255",
            "fax_number": "210-292-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6255",
            "fax_number": "210-292-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURKE",
        "first_name": "DALTON",
        "middle_name": "STRYKER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "73098",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2026-04445",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "73098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.