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General NPI Number Information
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NPI Number | 1184769812
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Entity Type | Individual
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Provider Name | TRICIA LOIS BULLARD MSN RN CPNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 490 IH 10 N STE 100
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City | BEAUMONT
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State | TX
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Zip | 77702-1819
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Country | US
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Telephone | 409-212-9988
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Fax | 409-212-8449
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Provider Business Mailing Address
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Address Line | 1502 SADDLECREEK DR
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City | HOUSTON
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State | TX
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Zip | 77090-2136
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Country | US
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Telephone | 281-397-0388
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Fax | 281-397-0388
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP105033
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 256934
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License Number State | TX
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