MEDICARE: DR. CHRISTIAN LEE MULLINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MED-PHYS-LIC-60652	MT

General Provider Information

NPI Number	:	1073583654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN LEE MULLINS M.D.

Provider Business Mailing Address
First Line	:	4288 GHOLSON RD UNIT C
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76705-1896
Country	:	US
Telephone Number	:	209-743-7696
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 TSCHACHE LN APT 206
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-2070
Country	:	US
Telephone Number	:	209-743-7696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	04/06/2026

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