Individual
DR. PATRICK C MCCULLOCH
Active
Individual
DR. PATRICK C MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M4338
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0918730002
DME MEDICARE PROVIDER NUMBER
TX
01
—
1366421679
BLUE CROSS BLUE SHIELD
TX
05
—
181848601
—
TX
05
—
181848602
—
TX
05
—
181848603
—
TX
05
—
181848605
—
TX
01
—
601771109
US DEPT OF LABOR
—
01
—
610197301 CENTERFIEL
US DEPT OF LABOR
TX
01
—
610197302 FANNIN
US DEPT OF LABOR
TX
01
—
616771101
US DEPT OF LABOR
—
01
—
616771105
US DEPT OF LABOR
—
01
—
616771110
US DEPT OF LABOR
—
01
—
P00842117
MEDICARE RAILROAD
TX
01
—
P01102952
RR MEDICARE
TX
Enumeration date
01/13/2006
Last updated
04/15/2014
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