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Organization
MICHAEL R. MCCULLOUGH, D.O., P.A.
Active
Organization
MICHAEL R. MCCULLOUGH, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R. MCCULLOUGH D.O. (PHYSICIAN)
(972) 988-1588
Entity
Organization
Contact information
Practice address
643 S GREAT SOUTHWEST PKWY, SUITE 101, GRAND PRAIRIE, TX 75051-1056
(972) 602-0615
Mailing address
643 S GREAT SOUTHWEST PKWY, SUITE 101, GRAND PRAIRIE, TX 75051-1056
(972) 602-0615
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H9682
TX
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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