Provider Demographics
NPI:1881634897
Name:HULL, THOMAS N (APN FNP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:N
Last Name:HULL
Suffix:
Gender:M
Credentials:APN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WALLER ST
Mailing Address - Street 2:ATTN: FINANCE, 5TH FLOOR
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-5240
Mailing Address - Country:US
Mailing Address - Phone:512-978-9000
Mailing Address - Fax:512-978-9001
Practice Address - Street 1:4614 N IH 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3401
Practice Address - Country:US
Practice Address - Phone:512-978-9100
Practice Address - Fax:512-448-8264
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650479363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124805607Medicaid
TX82N188Medicare PIN
S57131Medicare UPIN
TX124805607Medicaid