Individual provider Active NPI

David Ryan Mullican, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1518192475
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P0916 Issued in TX
Practice address
8353 Culebra Rd Ste 101
San Antonio, TX 78251-1903
Phone
(210) 706-2580
Fax
(210) 706-2582
NPI assigned
May 21, 2009
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P0916 TX Primary

Addresses

Primary practice location

8353 Culebra Rd Ste 101
San Antonio, TX 78251-1903

Mailing address

8353 Culebra Rd Ste 101
San Antonio, TX 78251-1903
Phone (210) 706-2580

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120628000652 TX Practitioner - Family Practice 2769647569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P0916TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine CurrentSince Jul 11, 2012 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jul 11, 2012 Accepting new patients

Locations

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

2833 Babcock Rd
Ste 203
San Antonio, TX 78229
Phone (210) 267-1709

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1518192475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8353 CULEBRA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511903",
            "telephone_number": "210-706-2580",
            "fax_number": "210-706-2582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8353 CULEBRA RD STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511903",
            "telephone_number": "210-706-2580",
            "fax_number": "210-706-2582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLICAN",
        "first_name": "DAVID",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P0916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.