Individual
JOHN PERRY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075
(972) 596-6800
Mailing address
1820 PRESTON PARK BLVD, 1200, PLANO, TX 75093-3656
(972) 867-7862
(972) 612-1623
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L0944
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170513901
—
TX
01
—
8C8701
COLLIN COUNTY PTAN
TX
Enumeration date
05/04/2006
Last updated
08/23/2013
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