Provider Demographics
NPI:1700022928
Name:CULLEY, MAUREEN A (PA)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:A
Last Name:CULLEY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2411 FOUNTAIN VIEW DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4817
Mailing Address - Country:US
Mailing Address - Phone:713-620-4000
Mailing Address - Fax:
Practice Address - Street 1:5420 WEST LOOP SOUTH
Practice Address - Street 2:STE. 3500
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77041
Practice Address - Country:US
Practice Address - Phone:713-664-2662
Practice Address - Fax:713-987-7691
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2013-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00364363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP03976Medicare UPIN