Micam W. Tullous, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G8470 Issued in TX

Practice address

315 N San Saba
Suite 1210
San Antonio, TX 78207-3154

Phone

(210) 354-0877

Fax

(210) 354-0880

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtullous415683@christushealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baylor College of Medicine

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1285079764
  Medicare reassignment NPD
• Christus Santa Rosa Health Care Corporation

  • Children's Hospital
  • San Antonio, TX
  • NPI 1821004151
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1295768463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE 1210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-354-0877",
            "fax_number": "210-354-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N SAN SABA",
            "address_2": "SUITE 1210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073154",
            "telephone_number": "210-354-0877",
            "fax_number": "210-354-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOUS",
        "first_name": "MICAM",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "G8470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "3339002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124306501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12430695-06",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Celina Salathiel Tuexi Alarcon, RBT
• Barbara Ann Tuitele, FNP
• Richard Tuli, M.D., PH.D.
• Julie A Tullberg, DO
• Matt Tullis, R.PH.
• Casey Jo Tully, MA, NCC, LPC
• John Tully, M.D.
• Natwashiel Tumbling, RBT
• Allison Gayle Tumlinson, DPT
• Kelvin Tung

• Neurological Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.