DR. MICHAEL REID MCCULLOUGH (NPI# 1932135704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932135704 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL REID MCCULLOUGH |
| Credential | DO |
| Practice Address |
643 S Great Southwest Pkwy Suite 101 Grand Prairie TX 75051-1056 |
| Practice Telephone | 9729881588 |
| Practice Fax Number | 9726020615 |
| Mailing Telephone | 9729881588 |
| Mailing Fax Number | 9726020615 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2019-08-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | H9682 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | AMERIGROUP ID | 10028878 | 01 |
| TX | TPI | 033519201 | 01 |
| TX | AETNA ID | 4250747 | 01 |
| TX | BLUE CROSS BLUE SHIELD ID | G74V | 01 |
| TX | 033519201 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962049593 | Michael Wayne Mccullough | Obstetrics & Gynecology | 500 N Keene St Ste 400, Columbia, MO 65201-8104 | 2019-12-02 |
| 1982704771 | Michael Lee Mccullough | Internal Medicine | 8411 Preston Road #200, Dallas, TX 75225 | 2006-09-22 |
| 1053415166 | Michael Warren Mccullough | Chiropractor | 6003 Overland Rd Ste 104, Ste 104, Boise, ID 83709 | 2006-09-11 |
| 1982692661 | Michael Patrick Mccullough | Podiatrist | 2200 Bryant Williams Drive, Suite 1, Klamath Falls, OR 97601-1121 | 2005-10-07 |
| 1639656523 | Michael Burks Mccullough | Optometrist | 3929 N Gloster St, Tupelo, MS 38804-0915 | 2018-07-24 |
| 1861830622 | Michael Scott Mccullough | Dentist | 11400 Palm Dr, Desert Hot Springs, CA 92240-3167 | 2013-06-13 |
| 1316298870 | Michael Allen Mccullough | Nurse Practitioner | 101 Yorktown Dr, Fayetteville, GA 30214-1578 | 2012-09-25 |
| 1255448122 | Michael Mccullough I | Emergency Medicine | 2823 Fresno St, Fresno, CA 93721-1324 | 2006-08-24 |
| 1902878903 | Michael Mccullough | Radiology | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2006-02-03 |
| 1447257019 | Michael David Mccullough | Radiology | Delaney Radiologists Group, Pllc, 1025 Medical Center Dr, Wilmington, NC 28401 | 2005-06-28 |
| Street Address |
643 S GREAT SOUTHWEST PKWY SUITE 101 |
| City | GRAND PRAIRIE |
| State | TX |
| Zip Code | 75051-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508852310 | Ralph Thane Wiegman | Obstetrics & Gynecology | 643 S Great Southwest Pkwy, Ste 102, Grand Prairie, TX 75051-1056 | 2005-09-27 |
| 1235571340 | Great Southwest Medical LLC | Clinic/Center | 643 S Great Southwest Pkwy, Suite 104, Grand Prairie, TX 75051-1056 | 2013-07-18 |
| 1275832362 | Michael R. Mccullough, D.o., P.a. | Obstetrics & Gynecology | 643 S Great Southwest Pkwy, Suite 101, Grand Prairie, TX 75051-1056 | 2011-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750940342 | Laura Burdette | Counselor | 2801 Oster Dr., Building A Suite 300, Grand Prairie, TX 75051 | 2019-06-07 |
| 1871087460 | Cam Chau Huynh | Pharmacist | 2615 W Pioneer Pwky Suite 139, Grand Prairie, TX 75051 | 2018-06-18 |
| 1710416060 | Squeece Services LLC | Private Vehicle | 2304 Oak Ln Dr Suite 201, Grand Prairie, TX 75051 | 2017-06-09 |
| 1477000883 | Marshall Anderson | Specialist/Technologist | 101 Gopher Boulevard, Grand Prairie, TX 75051 | 2016-09-01 |
| 1932570934 | By His Grace Housecalls Inc | Nurse Practitioner | 2305 Oak Ln Ste 106, Grand Prairie, TX 75051 | 2015-10-15 |
| 1225453921 | Perfection Housecalls of Texas LLC | Nurse Practitioner | 2755 Furlong Dr, Grand Prairie, TX 75051 | 2014-03-04 |
| 1669619300 | Parker Health Care Services Inc | Nursing Care | 2305 Oak Lane Ste 211, Grand Prairie, TX 75051 | 2009-01-16 |
| 1861639718 | Jacqueline Lanae Fort | Contractor | 842 Pangburn St, Grand Prairie, TX 75051 | 2009-01-14 |
| 1386841625 | Omolara Abitoye | Pediatrics | 688 W Pioneer Pkwy Ste 120, Grand Prairie, TX 75051 | 2007-06-29 |
| 1750584934 | Mai Tram Phan | Dentist | 2100 S Great Sw Pky, Suite #102, Grand Prairie, TX 75051 | 2007-06-06 |
| Find all providers in zip 75051 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962455402 | Egle Emilija Berzinskas | Obstetrics & Gynecology | 2210 N Hwy 360, Grand Prairie, TX 75050-1017 | 2006-05-18 |
| 1508852310 | Ralph Thane Wiegman | Obstetrics & Gynecology | 643 S Great Southwest Pkwy, Ste 102, Grand Prairie, TX 75051-1056 | 2005-09-27 |
| 1528063146 | Healthtexas Provider Network | Obstetrics & Gynecology | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6401 | 2005-06-20 |
| 1275832362 | Michael R. Mccullough, D.o., P.a. | Obstetrics & Gynecology | 643 S Great Southwest Pkwy, Suite 101, Grand Prairie, TX 75051-1056 | 2011-03-15 |
| 1962636761 | Fundime Elmazi | Obstetrics & Gynecology | 2740 N Hwy 360, Grand Prairie, TX 75050-6403 | 2009-05-07 |
| 1407802259 | James David Peters | Obstetrics & Gynecology | 2740 N Hwy 360, Suite 100, Grand Prairie, TX 75050-6403 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677067 | Rodriguez Health, LLC | Obstetrics & Gynecology | 107 N Smith St Ste B, Pleasanton, TX 78064-4109 | 2020-10-17 |
| 1093324428 | Complete Care Obgyn and Family Medicine Pllc | Obstetrics & Gynecology | 1408 W Nasa Parkway, Ste A, Webster, TX 77598 | 2020-07-31 |
| 1891303673 | Serenity Women's Health Pllc | Obstetrics & Gynecology | 10907 Memorial Hermann Dr Ste 355, Pearland, TX 77584-4114 | 2020-07-17 |
| 1659994069 | Carolina A Andrade | Obstetrics & Gynecology | 945 S Mesa Hills Dr Apt 3515, El Paso, TX 79912-5157 | 2020-05-20 |
| 1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
| 1508487273 | Victoria Ann Petruzzi | Obstetrics & Gynecology | 1401 St. Joseph Pkwy., Sks1106a, Houston, TX 77002 | 2020-05-04 |
| 1457972721 | Brynna Lynch | Obstetrics & Gynecology | 11212 State Highway 151 Ste 120, San Antonio, TX 78251-4498 | 2020-04-28 |
| 1952933913 | Gilbert G Sayegh Md, Pa | Obstetrics & Gynecology | 1004 Hobbs Hwy Ste 4, Seminole, TX 79360-3310 | 2020-02-07 |
| 1346880184 | Burke Womens Healthcare Pllc | Obstetrics & Gynecology | 4002 Burke Rd Ste 300, Pasadena, TX 77504-3451 | 2020-01-09 |
| 1386280337 | Women's Pavilion of Greater Houston | Obstetrics & Gynecology | 6051 Garth Rd Ste 700, Baytown, TX 77521-9807 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | GRAND PRAIRIE |
| Zip Code | 75051 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.