Provider Demographics
NPI:1538169040
Name:HULL, BRIAN COTTRELL (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:COTTRELL
Last Name:HULL
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2303
Mailing Address - Country:US
Mailing Address - Phone:940-764-5200
Mailing Address - Fax:
Practice Address - Street 1:4909 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2547
Practice Address - Country:US
Practice Address - Phone:940-691-0985
Practice Address - Fax:940-687-4647
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9095207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164840-05Medicaid
TX1164840-05Medicaid