Provider Demographics
NPI:1376603464
Name:DRULEY, JOHN D (LICENSED SPECIALIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:DRULEY
Suffix:
Gender:M
Credentials:LICENSED SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 N 2ND ST STE 500
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2593
Mailing Address - Country:US
Mailing Address - Phone:956-632-0908
Mailing Address - Fax:956-632-0909
Practice Address - Street 1:4100 N 2ND ST STE 500
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2593
Practice Address - Country:US
Practice Address - Phone:956-632-0908
Practice Address - Fax:956-632-0909
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178492801Medicaid