Healthcare Provider Details

I. General information

NPI: 1215974373
Provider Name (Legal Business Name): BULLARD FAMILY MEDICINE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 HIGHWAY 69 NORTH
BULLARD TX
75757
US

IV. Provider business mailing address

395 HIGHWAY 69 N
BULLARD TX
75757-0139
US

V. Phone/Fax

Practice location:
  • Phone: 903-360-6846
  • Fax:
Mailing address:
  • Phone: 903-360-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES HARRIS DURRETT
Title or Position: OWNER
Credential: M.D.
Phone: 903-360-6846