# KULM MEDICAL PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Liberty Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588824817
- **Authorized official:** DR. MARK HEAVER DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (214) 275-7200

## Contact information

- **Practice address:** 4301 SATURN RD, SUITE 201, GARLAND, TX 75041-5323
- **Practice address phone:** (214) 275-7200
- **Practice address fax:** (214) 703-3354
- **Mailing address:** 4301 SATURN RD, SUITE 201, GARLAND, TX 75041-5323
- **Mailing address phone:** (214) 275-7200
- **Mailing address fax:** (214) 703-3354

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 10858 | TX | — |
| 111N00000X | Chiropractor | 2503 | TX | — |
| 111N00000X | Chiropractor | 4175 | TX | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | E7114 | TX | Yes |
| 208D00000X | General Practice Physician | H2662 | TX | — |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 06/12/2008