Individual
MS. AMY DAVIS TULLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST/CFA, LSA
Contact information
Practice address
4601 DRESDEN DR, GRANBURY, TX 76049-5048
(817) 578-0891
Mailing address
4601 DRESDEN DR, GRANBURY, TX 76049-5048
(817) 578-0891
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00052
TX
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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