Individual
MRS. AMBER GAYLE MCMULLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1901 W HIGHWAY 90, ALPINE, TX 79830-3311
(432) 837-5918
(432) 837-9937
Mailing address
2525 N GRANDVIEW AVE STE 400, ODESSA, TX 79761-1621
(432) 550-4700
(432) 550-4715
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1167940
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366720601
—
TX
01
—
8TAE46
BLUE CROSS BLUE SHIELD TEXAS
TX
Enumeration date
08/02/2006
Last updated
07/21/2022
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