Provider Demographics
NPI:1245522192
Name:THOMAS F PULLEN, MD
Entity type:Organization
Organization Name:THOMAS F PULLEN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-352-3200
Mailing Address - Street 1:601A MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-1214
Mailing Address - Country:US
Mailing Address - Phone:512-352-3200
Mailing Address - Fax:512-352-3201
Practice Address - Street 1:601A MALLARD LN
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-1214
Practice Address - Country:US
Practice Address - Phone:512-352-3200
Practice Address - Fax:512-352-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty