Provider Demographics
NPI:1467532747
Name:MULLICAN, MORGAN PAUL (DC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:PAUL
Last Name:MULLICAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 TRINITY MILLS RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7603
Mailing Address - Country:US
Mailing Address - Phone:972-248-3101
Mailing Address - Fax:972-248-3615
Practice Address - Street 1:4222 TRINITY MILLS RD
Practice Address - Street 2:SUITE 114
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7603
Practice Address - Country:US
Practice Address - Phone:972-248-3101
Practice Address - Fax:972-248-3615
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A1762OtherBC/BS
TX8A1762OtherBC/BS
TX603180Medicare ID - Type Unspecified