MEDICARE: DR. THOMAS F. PULLEN JR. M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E2801	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00027317	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952396731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS F. PULLEN JR. M.D.

Provider Business Mailing Address
First Line	:	601A MALLARD LN
Second Line	:
City	:	TAYLOR
State	:	TX
Zip	:	76574-1214
Country	:	US
Telephone Number	:	512-352-3200
Fax Number	:	512-352-3201

Provider Business Practice Location Address
First Line	:	601A MALLARD LN
Second Line	:
City	:	TAYLOR
State	:	TX
Zip	:	76574-1214
Country	:	US
Telephone Number	:	512-352-3200
Fax Number	:	512-352-3201

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	05/11/2011

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