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General NPI Number Information
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NPI Number | 1518168640
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Entity Type | Individual
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Provider Name | DANIEL RICHARD THULL PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 7207 WINTERWOOD PL
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4171
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Country | US
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Telephone | 210-316-9896
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 E COURT ST
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City | SEGUIN
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State | TX
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Zip | 78155-5130
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Country | US
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Telephone | 830-401-4401
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Fax | 830-303-5225
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PENDING
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License Number State | TX
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