Provider Demographics
NPI:1558582460
Name:MULLICAN, DAVID M (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
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 1:4021 BELT LINE RD
Mailing Address - Street 2:201
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4369
Mailing Address - Country:US
Mailing Address - Phone:972-980-4848
Mailing Address - Fax:
Practice Address - Street 1:4021 BELT LINE RD
Practice Address - Street 2:201
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4369
Practice Address - Country:US
Practice Address - Phone:972-980-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor