Provider Demographics
NPI:1437132644
Name:MARULL, JAVIER H (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:H
Last Name:MARULL
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 1:1010 E WHEATLAND RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4914
Mailing Address - Country:US
Mailing Address - Phone:972-283-0063
Mailing Address - Fax:972-283-0284
Practice Address - Street 1:5909 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6209
Practice Address - Country:US
Practice Address - Phone:214-879-3143
Practice Address - Fax:214-879-3164
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4328207L00000X, 207LP2900X
FLME91371207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8768B0Medicare ID - Type Unspecified
TXF68952Medicare UPIN