MEDICARE: BULLARD FAMILY MEDICINE, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1215974373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULLARD FAMILY MEDICINE, P.A.

Provider Business Mailing Address
First Line	:	395 HIGHWAY 69 N
Second Line	:
City	:	BULLARD
State	:	TX
Zip	:	75757-0139
Country	:	US
Telephone Number	:	903-360-6846
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 HIGHWAY 69 NORTH
Second Line	:
City	:	BULLARD
State	:	TX
Zip	:	75757
Country	:	US
Telephone Number	:	903-360-6846
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES HARRIS DURRETT
Credential	:	M.D.
Telephone Number	:	903-360-6846

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	08/22/2020

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