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Steven G Mccullough
Prosthetic/Orthotic Supplier in Tyler, Texas
NPI 1932363751

Steven G Mccullough is a Prosthetic/Orthotic Supplier based in Tyler, TX. Steven G Mccullough practices in Tyler, TX. The NPI Number for Steven G Mccullough is 1932363751 and holds a License No. 101171 (Texas).

The current practice location address for Steven G Mccullough is 1120 Medical Dr, Tyler, TX and can be reached out via phone at 903-592-5900 and via fax at 903-592-6683.

Location: 1120 Medical Dr, Tyler, TX, 75701-2109
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1932363751
Provider Name
Steven G Mccullough
Credential
Provider Entity Type
Organization
Address
1120 Medical Dr, Tyler, TX, 75701-2109
Phone Number
903-592-5900
Fax Number
903-592-6683
Provider Enumeration Date
07/10/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
087070101 05 TX
institution
Provider Business Practice Location Address Details
Address
1120 Medical Dr
City
Tyler
State
Texas
Zip
75701-2109
Phone Number
903-592-5900
Fax Number
903-592-6683
person
Provider Business Mailing Address Details
Address
1120 Medical Dr
City
Tyler
State
Texas
Zip
75701-2109
Phone Number
903-592-5900
Fax Number
903-592-6683
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
101171 (Texas)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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