Provider Demographics
NPI:1023371804
Name:CLIFFORD D. MULLINS, D.C., P.C.
Entity Type:Organization
Organization Name:CLIFFORD D. MULLINS, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PC
Authorized Official - Phone:903-566-4449
Mailing Address - Street 1:14653 EASTSIDE RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-6729
Mailing Address - Country:US
Mailing Address - Phone:903-566-4449
Mailing Address - Fax:
Practice Address - Street 1:14653 EASTSIDE RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-6729
Practice Address - Country:US
Practice Address - Phone:903-566-4449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3057261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center