Provider Demographics
NPI:1679750459
Name:SAMUEL A. TYULUMAN, M.D., P.A.
Entity Type:Organization
Organization Name:SAMUEL A. TYULUMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:TYULUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-368-3755
Mailing Address - Street 1:9301 N CENTRAL EXPY
Mailing Address - Street 2:#475 MB #60
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0806
Mailing Address - Country:US
Mailing Address - Phone:214-368-3755
Mailing Address - Fax:214-368-3758
Practice Address - Street 1:9301 N CENTRAL EXPY
Practice Address - Street 2:#475 MB #60
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0806
Practice Address - Country:US
Practice Address - Phone:214-368-3755
Practice Address - Fax:214-368-3758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2855207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty