Provider Demographics
NPI:1225073216
Name:WATUMULL, DENTON (MD)
Entity Type:Individual
Prefix:DR
First Name:DENTON
Middle Name:
Last Name:WATUMULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 GEORGE BUSH HWY
Mailing Address - Street 2:#101
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3566
Mailing Address - Country:US
Mailing Address - Phone:972-470-5000
Mailing Address - Fax:972-470-5002
Practice Address - Street 1:3201 GEORGE BUSH HWY
Practice Address - Street 2:#101
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3566
Practice Address - Country:US
Practice Address - Phone:972-470-5000
Practice Address - Fax:972-470-5002
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG60962086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPO88X1212Medicaid
E82741Medicare UPIN
TXPO88X1212Medicaid