Healthcare Provider Details

I. General information

NPI: 1649553850
Provider Name (Legal Business Name): ANDREW ROBERT TULLMAN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 HILL COUNTRY DR STE C
KERRVILLE TX
78028-6043
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 830-792-5800
  • Fax:
Mailing address:
  • Phone: 830-730-5025
  • Fax: 830-730-4207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA09041
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: