Provider Demographics
NPI:1699909135
Name:CULVER, THERESA ELIZABETH (MT(ASCP))
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ELIZABETH
Last Name:CULVER
Suffix:
Gender:F
Credentials:MT(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LEGACY DR APT 1924
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-2239
Mailing Address - Country:US
Mailing Address - Phone:443-365-6903
Mailing Address - Fax:
Practice Address - Street 1:701 LEGACY DR APT 1924
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-2239
Practice Address - Country:US
Practice Address - Phone:443-365-6903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTN 38571246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist