Individual provider Active NPI

Julie A Tullberg, DO

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1619048626
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S3604 Issued in TX
Practice address
19238 Stonehue
San Antonio, TX 78258-3447
Phone
(830) 625-9153
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S3604 TX Primary

Addresses

Primary practice location

19238 Stonehue
San Antonio, TX 78258-3447

Mailing address

19238 Stonehue
San Antonio, TX 78258-3447
Phone (830) 625-9153

Other practice location 1

5625 Eiger Rd Ste 225
Austin, TX 78735-8983
Phone (512) 447-5588

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
S3604TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TCH Pediatric Associates, Inc Pediatrics PastSince Sep 1, 2020 Accepting new patients
TCH Pediatric Associates, Inc Pediatrics PastSince Sep 1, 2020 Accepting new patients
Abcd Pediatrics Pediatrics PastSince Sep 4, 2022 Accepting new patients
Topcare Medical Group Inc PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619048626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19238 STONEHUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583447",
            "telephone_number": "830-625-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19238 STONEHUE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583447",
            "telephone_number": "830-625-9153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5625 Eiger Rd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787358983",
            "country_code": "US",
            "telephone_number": "512-447-5588",
            "fax_number": "125-447-6990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLBERG",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S3604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.