Organization
M.GAYLE MULLANAX, MD PA
Active
Other names
MULLANAX DERMATOLOGY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILTON GAYLE MULLANAX M.D. (OWNER)
(817) 261-1626
Entity
Organization
Contact information
Practice address
715 N FIELDER RD, ARLINGTON, TX 76012-4695
(817) 261-1626
(817) 275-0441
Mailing address
715 N FIELDER RD, ARLINGTON, TX 76012-4695
(817) 261-1626
(817) 275-0441
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D1750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007DQ
BCBS OF TEXAS
TX
Enumeration date
04/11/2007
Last updated
06/25/2009
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