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Individual

MARY ANN MULLICAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5323 HARRY HINES BLVD, DEPARTMENT OF RADIOLOGY, DALLAS, TX 75390-8896
(214) 648-8018
(214) 648-2678
Mailing address
5323 HARRY HINES BLVD, DEPARTMENT OF RADIOLOGY, DALLAS, TX 75390-8896
(214) 648-8018
(214) 648-2678

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D4534
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114188903
TX
Enumeration date
04/28/2006
Last updated
03/25/2011
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