Mccullough, Michael Reid
Mccullough, Michael Reid is an sole proprietor health care provider with primary practice located at 643 S Great Southwest Pkwy Suite 101, Grand Prairie TX 75051-1056. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics is his primary health care specialty. Mccullough, Michael Reid can be contacted via phone (972) 988-1588.Contact Information
Primary practice address
643 S Great Southwest Pkwy Suite 101
Grand Prairie TX 75051-1056
Phone: (972) 988-1588
Fax: (972) 602-0615
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | H9682 | Texas |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | H9682 | Texas |
Profile Details
| NPI number | 1932135704 |
|---|---|
| LBN Legal business name | Mccullough, Michael Reid |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 24th, 2006 |
| Last updated | Jan 18th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932135704 | NPPES |
| Texas | MEDICAID | 033519201 | |
| Texas | Other | 10028878 | |
| Texas | MEDICAID | 1275832362 | |
| Texas | Other | 4250747 | |
| Texas | Other | G74V | |
| Texas | Other | 033519201 |
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