MEDICARE: MS. AUNDRA MCMULLEN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	568946544	OTHER	BCBS
2	5874	OTHER	HEALTH PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952126088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AUNDRA MCMULLEN

Provider Business Mailing Address
First Line	:	2379 BRIARWEST BLVD UNIT 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5697
Country	:	US
Telephone Number	:	305-528-9576
Fax Number	:

Provider Business Practice Location Address
First Line	:	2379 BRIARWEST BLVD UNIT 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5697
Country	:	US
Telephone Number	:	305-528-9576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	11/22/2024

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