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General NPI Number Information
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NPI Number | 1720494503
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Entity Type | Individual
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Provider Name | CELSO E TUMULAK JR. FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2121 E GRIFFIN PKWY STE 10
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City | MISSION
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State | TX
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Zip | 78572-3072
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Country | US
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Telephone | 956-583-7393
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Fax | 956-583-7309
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Provider Business Mailing Address
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Address Line | PO BOX 850001, DEPT 8340
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City | ORLANDO
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State | FL
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Zip | 32885-0001
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Country | US
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Telephone | 813-536-7277
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Fax | 855-830-1722
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP125775
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License Number State | TX
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