Sullivan, John M

Sullivan, John M is an sole proprietor health care provider with primary practice located at 802 W Lampasas St , Ennis TX 75119-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Sullivan, John M can be contacted via phone (972) 878-4700.

Contact Information

Primary practice address
802 W Lampasas St Ennis TX 75119-4500
Phone: (972) 878-4700
Fax: (972) 878-2238
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X K5708 Texas
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X K5708 Texas

Profile Details

NPI number 1336132117
LBN Legal business name Sullivan, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 26th, 2005
Last updated Jan 13th, 2010 - about 16 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 1336132117 NPPES
Texas MEDICAID 138206115
Texas Other 8A7520

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