Dalton Bourke, MD
Dalton Bourke, MD is a Child & Adolescent Psychiatry Physician in San Antonio, TX, registered under NPI 1134623804. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 1100 WILFORD HALL LOOP BLDG 4554, San Antonio, TX 78236. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 73098 | WI | Psychiatry Physician |
| 2026-04445 | NC | Psychiatry Physician |
| 73098 | WI | Child & Adolescent Psychiatry Physician primary |
Licences are recorded in 2 states: WI, NC. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Psychiatry
- PAC ID
- 6406104611
Enrolled in Medicare 3 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Wisconsin | I20260407000196 | Practitioner - Psychiatry |
| Massachusetts | I20260612003539 | Practitioner - Psychiatry |
| Virginia | I20260617003317 | Practitioner - Psychiatry |
Medicare enrolment is recorded as approved under the provider type Practitioner - Psychiatry. There are 3 separate enrolment records across 3 states (WI, MA, VA). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: North Carolina and Wisconsin. Multi-state licensure often means the provider works near a state border, covers more than one office, or delivers care by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Child & Adolescent Psychiatry covers
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. NUCC Health Care Provider Taxonomy, code 2084P0804X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2084P0800X | Psychiatry Physician Psychiatry | 73098 | WI | |
| 2084P0800X | Psychiatry Physician Psychiatry | 2026-04445 | NC | |
| 2084P0804X | Child & Adolescent Psychiatry Physician Child & Adolescent Psychiatry | 73098 | WI | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1134623804 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Mar 19, 2018 |
| Last updated | Aug 20, 2026 |
| Status | Active |
| Sole proprietor | No |
| Gender | Male |
| Credential | MD |
| Practice address |
1100 WILFORD HALL LOOP BLDG 4554 San Antonio, TX 78236 (210) 292-6255 Fax (210) 292-7934 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 3 | 4 | 6 | 2 | 3 | 8 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 6 | 4 | 3 | 2 | 6 | 8 | 0 |
Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.