Cully, Tara Lee

Cully, Tara Lee is an individual health care provider with primary practice located at 1100 W Reynosa Ave , De Leon TX 76444-1630. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Cully, Tara Lee can be contacted via phone (254) 893-5895.

Contact Information

Primary practice address
1100 W Reynosa Ave De Leon TX 76444-1630
Phone: (254) 893-5895
Fax: (254) 893-5222
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 27263 Texas

Profile Details

NPI number 1538447685
LBN Legal business name Cully, Tara Lee
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2011
Last updated Mar 25th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538447685 NPPES
Texas Other 27263 LICENSE
Texas MEDICAID 126862508 LICENSE

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