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Shir'mel Candis Mccullough
Military Health Care Provider in San Angelo, Texas
NPI 1629775499

Shir'mel Candis Mccullough is a Military Health Care Provider based in Columbia, TX. Shir'mel Candis Mccullough practices in San Angelo, TX. The NPI Number for Shir'mel Candis Mccullough is 1629775499 and holds a License No. (Texas).

The current practice location address for Shir'mel Candis Mccullough is 271 Ft. Richardson Avenue, San Angelo, TX and can be reached out via phone at 325-654-3221 and via fax at 325-654-1161.

Location: 271 Ft. Richardson Avenue, San Angelo, TX, 29208-4001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629775499
Provider Name
Shir'mel Candis Mccullough
Credential
Provider Entity Type
Individual
Gender
Female
Address
271 Ft. Richardson Avenue, San Angelo, TX, 29208-4001
Phone Number
325-654-3221
Fax Number
325-654-1161
Provider Enumeration Date
02/13/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
271 Ft. Richardson Avenue
City
San Angelo
State
Texas
Zip
76908-4902
Phone Number
325-654-3221
Fax Number
325-654-1161
person
Provider Business Mailing Address Details
Address
271 Ft. Richardson Avenue
City
San Angelo
State
Texas
Zip
76908-4902
Phone Number
325-654-3221
Fax Number
325-654-1161
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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