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Organization
KULM MEDICAL PA
Active
Organization
KULM MEDICAL PA
Active
Other names
Liberty Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK HEAVER DO (MEDICAL DIRECTOR)
(214) 275-7200
Entity
Organization
Contact information
Practice address
4301 SATURN RD, SUITE 201, GARLAND, TX 75041-5323
(214) 275-7200
(214) 703-3354
Mailing address
4301 SATURN RD, SUITE 201, GARLAND, TX 75041-5323
(214) 275-7200
(214) 703-3354
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
10858
TX
111N00000X
Chiropractor
2503
TX
111N00000X
Chiropractor
4175
TX
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
E7114
TX
208D00000X
General Practice Physician
H2662
TX
Other
Enumeration date
06/10/2008
Last updated
06/12/2008
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