Active NPI
Jonathan Eugene Pullen
- Specialist
- Austin, TX
National Provider Identifier
1013438589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 14889
- Practice address
- 12034 Research Blvd Ste 8
Austin, TX 78759-2405 - Phone
- (512) 331-6121
- NPI assigned
- Jul 5, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 14889 | TX | Primary |
Addresses
Primary practice location
12034 Research Blvd Ste 8
Austin, TX 78759-2405
Mailing address
3404 Willowrun CV Apt C
Austin, TX 78704-7373
Phone (832) 738-3469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14889 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499212800000",
"number": "1013438589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3404 WILLOWRUN CV APT C",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787047373",
"telephone_number": "832-738-3469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12034 RESEARCH BLVD STE 8",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787592405",
"telephone_number": "512-331-6121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLEN",
"first_name": "JONATHAN",
"middle_name": "EUGENE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-05",
"last_updated": "2017-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "14889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.