Individual
ROBBIE MCCULLOUGH IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 CUTTINGHAM CT, COPPELL, TX 75019-3733
(972) 998-3181
Mailing address
6600 LBJ FWY, SUITE 188, DALLAS, TX 75240-6514
(972) 998-3181
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
47-4733195
TX
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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