Individual
CLAYTON LOUIS PULLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7913 BANDERA RD, SAN ANTONIO, TX 78250-6511
(210) 680-9393
(210) 681-7906
Mailing address
PO BOX 680819, SAN ANTONIO, TX 78268-0819
(210) 680-9393
(210) 681-7906
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J8726
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
J8726
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076EG
BCBS
TX
01
—
0088MC
BCBS GROUP ID
TX
01
—
080187389
MEDICARE RAILROAD
—
01
—
J8726
STATE LICENSE
TX
Enumeration date
07/12/2005
Last updated
02/16/2009
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