Provider Demographics
NPI:1740289610
Name:MCMULLEN, PAUL EARL (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EARL
Last Name:MCMULLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 W WACO DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7105
Mailing Address - Country:US
Mailing Address - Phone:254-752-1331
Mailing Address - Fax:254-752-6452
Practice Address - Street 1:3801 W WACO DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7105
Practice Address - Country:US
Practice Address - Phone:254-752-1331
Practice Address - Fax:254-752-6452
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
TX2747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT14769Medicare UPIN
601008Medicare ID - Type Unspecified