Individual
DR. JOHN TULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 DALLAS ST, EMERGENCY ROOM, SAN ANTONIO, TX 78205-1201
(210) 614-0180
(210) 615-7170
Mailing address
PO BOX 12740, WESTMINSTER, CA 92685-2740
(562) 809-3527
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
L9524
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168435901
—
TX
05
—
168435902
—
TX
01
—
8M8132
BCBS
TX
Enumeration date
08/31/2005
Last updated
11/02/2009
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