Provider Demographics
NPI:1689623597
Name:TULI, NAMITA (MD)
Entity Type:Individual
Prefix:
First Name:NAMITA
Middle Name:
Last Name:TULI
Suffix:
Gender:F
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:PO BOX 1368
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-8368
Mailing Address - Country:US
Mailing Address - Phone:405-745-9600
Mailing Address - Fax:
Practice Address - Street 1:10141 US 59TH
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-7224
Practice Address - Country:US
Practice Address - Phone:979-531-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0802174400000X
MDD0063730208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00332447OtherMEDICARE RAILROAD
MD343MO103Medicare PIN