Healthcare Provider Details

I. General information

NPI: 1275015885
Provider Name (Legal Business Name): CARMEN PURL MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 GUY LANE PLZ
DUMAS TX
79029
US

IV. Provider business mailing address

PO BOX 1759
DUMAS TX
79029-1759
US

V. Phone/Fax

Practice location:
  • Phone: 806-948-1459
  • Fax: 806-948-1459
Mailing address:
  • Phone: 806-948-1459
  • Fax: 806-717-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARMEN PURL
Title or Position: DIRECTOR
Credential: MD
Phone: 806-948-1459