MEDICARE: PULL-UP A VETERANS HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251K00000X	Public Health or Welfare Agency
2	252Y00000X	Early Intervention Provider Agency
3	343900000X	Non-emergency Medical Transport (VAN)
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1871038950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULL-UP A VETERANS HOME

Provider Business Mailing Address
First Line	:	6803 IJAZ DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4977
Country	:	US
Telephone Number	:	254-652-0304
Fax Number	:

Provider Business Practice Location Address
First Line	:	7012 ESCONDIDO DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5422
Country	:	US
Telephone Number	:	254-652-0304
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	MIYORI T PULLEN
Credential	:	LMSW
Telephone Number	:	254-652-0304

Provider Enumeration Date	:	12/29/2016
Last Update Date	:	08/22/2023

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Directions to “PULL-UP A VETERANS HOME ” Practice Location

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