Organization
KULM MEDICAL PA
Active
Other names
Liberty Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK HEAVER DO (MEDICAL DIRECTOR)
(214) 275-7200
Entity
Organization
Contact information
Practice address
4301 SATURN RD, SUITE 201, GARLAND, TX 75041-5323
(214) 275-7200
(214) 703-3354
Mailing address
4301 SATURN RD, SUITE 201, GARLAND, TX 75041-5323
(214) 275-7200
(214) 703-3354
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
10858
TX
111N00000X
Chiropractor
2503
TX
111N00000X
Chiropractor
4175
TX
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
E7114
TX
208D00000X
General Practice Physician
H2662
TX
Other
Enumeration date
06/10/2008
Last updated
06/12/2008
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