Dr Tara Lee Cully, DDS is a medicare enrolled "Dentist - General Practice" provider in De Leon, Texas. Her current practice location is
1100 W Reynosa Ave, De Leon, Texas. You can reach out to her office (for appointments etc.) via phone at
(254) 893-5895.
Dr Tara Lee Cully is licensed to practice in Texas (license number 27263) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1538447685.
Healthcare Provider's Profile
| Full Name | Dr Tara Lee Cully |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 1100 W Reynosa Ave, De Leon, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538447685
- Provider Enumeration Date: 07/22/2011
- Last Update Date: 03/25/2019
Medicare PECOS Information:
- PECOS PAC ID: 2264722172
- Enrollment ID: I20160606001863
Medical Identifiers
Medical identifiers for Dr Tara Lee Cully such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538447685 | NPI | - | NPPES |
| 27263 | Other | TX | LICENSE |
| 126862508 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 27263 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Tara Lee Cully is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Tara Lee Cully, DDS
1100 W Reynosa Ave,
De Leon, TX 76444-1630
Ph: (254) 893-5895 | Dr Tara Lee Cully, DDS
1100 W Reynosa Ave,
De Leon, TX 76444-1630
Ph: (254) 893-5895 |
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