Individual provider Active NPI

Tyra Renay Burks, M.A CCC-SLP

  • Speech-Language Pathologist
  • Irving, TX
National Provider Identifier
1265169155
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
117391 Issued in TX
Practice address
1431 Greenway Dr Ste 500
Irving, TX 75038-2444
Phone
(214) 467-9787
NPI assigned
Aug 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 117391 TX Primary

Addresses

Primary practice location

1431 Greenway Dr Ste 500
Irving, TX 75038-2444

Mailing address

1501 Westridge Dr
Plano, TX 75075-8570

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 Arts

State licenses

LicenseStateTypeSpecialty
117391TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy 2000 Inc CurrentSince Nov 19, 2023 Accepting new patients
Green Apple LLC CurrentSince Nov 19, 2023 Accepting new patients
Synaptic Pediatric Therapies, LLC. Speech-Language Pathologist PastSince Aug 1, 2022 Accepting new patients

Locations

1431 Greenway Dr
Ste 500
Irving, TX 75038
Phone (214) 467-9787

Organizations & group practices 3

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": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1265169155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WESTRIDGE DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 GREENWAY DR STE 500",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382444",
            "telephone_number": "214-467-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "TYRA",
        "middle_name": "RENAY",
        "credential": "M.A CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "117391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.