Provider Demographics
NPI:1841207479
Name:CULLINANE, KATHLEEN SUSAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:SUSAN
Last Name:CULLINANE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 COUNTRY PLACE PKWY STE 113
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5121
Mailing Address - Country:US
Mailing Address - Phone:713-436-8346
Mailing Address - Fax:713-436-8356
Practice Address - Street 1:1801 COUNTRY PLACE PKWY
Practice Address - Street 2:SUITE 113
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5120
Practice Address - Country:US
Practice Address - Phone:713-436-8346
Practice Address - Fax:713-436-8356
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S7630OtherBLUE CROSS/ BLUE SHIELD
TX8S7630OtherBLUE CROSS/ BLUE SHIELD
TX8F1758Medicare ID - Type Unspecified