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General NPI Number Information
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NPI Number | 1952309114
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Entity Type | Individual
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Provider Name | CLAYTON LOUIS PULLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 7913 BANDERA RD
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City | SAN ANTONIO
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State | TX
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Zip | 78250-6511
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Country | US
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Telephone | 210-680-9393
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Fax | 210-681-7906
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Provider Business Mailing Address
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Address Line | PO BOX 680819
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City | SAN ANTONIO
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State | TX
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Zip | 78268-0819
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Country | US
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Telephone | 210-680-9393
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Fax | 210-681-7906
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J8726
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | J8726
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License Number State | TX
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