Individual provider Active NPI

Samuel W. Cullison, MD

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1972674976
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P7755 Issued in TX
Practice address
3500 W Wheatland Rd
Dallas, TX 75237-3460
Phone
(214) 947-5400
Fax
(214) 947-5425
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00015191 WA
Family Medicine Physician 207Q00000X P7755 TX Primary

Addresses

Primary practice location

3500 W Wheatland Rd
Dallas, TX 75237-3460

Mailing address

3500 W Wheatland Rd
Dallas, TX 75237-3460
Phone (214) 947-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

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": "1633478400000",
    "number": "1972674976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 W WHEATLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373460",
            "telephone_number": "214-947-5400",
            "fax_number": "214-947-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 W WHEATLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373460",
            "telephone_number": "214-947-5400",
            "fax_number": "214-947-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLISON",
        "first_name": "SAMUEL",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00015191",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P7755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.