| Doctor Name: | CARL L MCMULLEN |
| NPI Number: | 1164718623 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 1012 |
| Business Practice Address: | 3851 Roger Brooke Dr Graduate Medical Education San Antonio, TX - 782344501 |
| Business Phone Number: | 2105138078 |
| Business Fax Number: | |
| Mailing Address: | 3851 Roger Brooke Dr, Graduate Medical Education SAN ANTONIO |
| State: | TX |
| Postal Code: | 782344501 |
| Phone Number: | 2102717979 |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2011 |
| NPI Last Update Date: | 07/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1012 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |