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General NPI Number Information
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NPI Number | 1285641027
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Entity Type | Organization
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Legal Business Name | DOUGLAS N. MCMULLEN MD PA
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 2301 W NORTH LOOP BLVD
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City | AUSTIN
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State | TX
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Zip | 78756-2326
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Country | US
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Telephone | 512-452-2506
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Fax | 512-853-9685
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Provider Business Mailing Address
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Address Line | 2301 W NORTH LOOP BLVD
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City | AUSTIN
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State | TX
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Zip | 78756-2326
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Country | US
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Telephone | 512-452-2506
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Fax | 512-853-9685
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOUGLAS NELSON MCMULLEN
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Credential | MD
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Telephone | 512-452-2506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | F1810
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License Number State | TX
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