Organization
DANETTE R. ELLIOTT-MULLENS, DO, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANETTE RAI ELLIOTT-MULLENS DO (OWNER/PRESIDENT)
(830) 627-3385
Entity
Organization
Contact information
Practice address
2660 E. COMMON ST., STE #201, NEW BRAUNFELS, TX 78130-3168
(830) 627-3385
(830) 620-0294
Mailing address
2660 E. COMMON ST., STE. #201, NEW BRAUNFELS, TX 78130-3168
(830) 627-3385
(830) 620-0294
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K9775
TX
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
K9775
TX
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006QF
BCBS GROUP PROV #
TX
05
—
154062701
—
TX
Enumeration date
05/21/2007
Last updated
03/10/2010
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