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General NPI Number Information
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NPI Number | 1093786931
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Entity Type | Individual
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Provider Name | WILLIAM T MCCULLOUGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 1101 RAINTREE CIR STE 120
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City | ALLEN
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State | TX
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Zip | 75013
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Country | US
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Telephone | 214-817-9301
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Fax | 217-214-5948
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Provider Business Mailing Address
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Address Line | 1101 RAINTREE CIR STE 120
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City | ALLEN
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State | TX
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Zip | 75013-5292
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Country | US
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Telephone | 469-656-9041
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Fax | 469-656-9046
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | Q4201
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License Number State | TX
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