Organization Active NPI

Victorian Healthcare

  • Psychiatric/Mental Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1437610334
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VICTORIAN HEALTHCARE
Doing business as
Victorian Healthcare
Practice address
2602 Martin Luther King Jr Blvd
Dallas, TX 75215-2309
Phone
(940) 465-8760
NPI assigned
Mar 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Nathaniel Burks
Title
Co-Owner
Phone
(469) 386-5733

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

2602 Martin Luther King Jr Blvd
Dallas, TX 75215-2309

Mailing address

1436 Bobing Dr
Lewisville, TX 75067-6041
Phone (469) 386-5733

Other names 1

  • Victorian Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190611000101 TX Part B Supplier - Clinic/Group Practice 6608109483 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

2602 Martin Luther King Jr Blvd
Dallas, TX 75215
Phone (214) 421-0821

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1437610334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 BOBING DR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750676041",
            "telephone_number": "469-386-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 MARTIN LUTHER KING JR BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752152309",
            "telephone_number": "940-465-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIAN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "BURKS",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "469-386-5733"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victorian Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Victorian Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.