Provider Demographics
NPI:1144204330
Name:TRULSON, TAMELLA J (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMELLA
Middle Name:J
Last Name:TRULSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2150 LAKESIDE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4302
Mailing Address - Country:US
Mailing Address - Phone:972-437-4698
Mailing Address - Fax:972-690-9309
Practice Address - Street 1:2150 LAKESIDE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4302
Practice Address - Country:US
Practice Address - Phone:972-437-4698
Practice Address - Fax:972-690-9309
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ23842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG18148Medicare UPIN
TX8944B7Medicare ID - Type Unspecified
TX81C903Medicare PIN