Provider Demographics
NPI:1093767402
Name:MARULLO, PAUL W (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:MARULLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3009 STRAWBERRY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-5216
Mailing Address - Country:US
Mailing Address - Phone:713-941-2110
Mailing Address - Fax:713-941-2125
Practice Address - Street 1:3009 STRAWBERRY RD
Practice Address - Street 2:SUITE B
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-5216
Practice Address - Country:US
Practice Address - Phone:713-941-2110
Practice Address - Fax:713-941-2125
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX885392OtherCOVENTRY & FIRST HEALTH
TX8J5005OtherBLUE CROSS BLUE SHIELD
TX8G5645Medicare ID - Type Unspecified