Active NPI
Stacee Burson, D.M.D., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Texarkana, TX
National Provider Identifier
1225033475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 17537
- Practice address
- 5508 Cowhorn Creek Rd
Texarkana, TX 75503-9101 - Phone
- (903) 334-8080
- NPI assigned
- Jun 15, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 17537 | TX | Primary |
Addresses
Primary practice location
5508 Cowhorn Creek Rd
Texarkana, TX 75503-9101
Mailing address
5508 Cowhorn Creek Rd
Texarkana, TX 75503-9101
Phone (903) 334-8080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17537 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225033475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5508 COWHORN CREEK RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755039101",
"telephone_number": "903-334-8080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5508 COWHORN CREEK RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755039101",
"telephone_number": "903-334-8080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURSON",
"first_name": "STACEE",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "17537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.