Provider Demographics
NPI:1033296124
Name:MCMULLEN, CHRISTINA K
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:K
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TEXAS LONGHORN TRL
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-3459
Mailing Address - Country:US
Mailing Address - Phone:512-858-1033
Mailing Address - Fax:512-858-1034
Practice Address - Street 1:200 TEXAS LONGHORN TRL
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-3459
Practice Address - Country:US
Practice Address - Phone:512-858-1033
Practice Address - Fax:512-858-1034
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies