Individual
KEVIN L. MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1216 JUNCTION HWY, KERRVILLE, TX 78028-4906
(830) 895-7858
Mailing address
1216 JUNCTION HWY, KERRVILLE, TX 78028-4906
(830) 895-7858
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2854T
TX
Other
Enumeration date
02/22/2007
Last updated
04/29/2008
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