Provider Demographics
NPI:1982085544
Name:MCCULLAR, EMILY (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:MCCULLAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 HORIZON RD STE 209
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7802
Mailing Address - Country:US
Mailing Address - Phone:972-771-2018
Mailing Address - Fax:
Practice Address - Street 1:3142 HORIZON RD STE 209
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7802
Practice Address - Country:US
Practice Address - Phone:972-771-2018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6832207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine