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General NPI Number Information
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NPI Number | 1437146230
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Entity Type | Individual
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Provider Name | TARA A DULLYE M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 8160 WALNUT HILL LN STE 219
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City | DALLAS
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State | TX
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Zip | 75231-4354
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Country | US
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Telephone | 214-369-2400
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Fax | 214-369-7528
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Provider Business Mailing Address
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Address Line | P.O. BOX 961205
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City | FORT WORTH
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State | TX
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Zip | 76161-1205
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Country | US
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Telephone | 817-740-8450
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K4327
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License Number State | TX
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