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General NPI Number Information
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NPI Number | 1245238815
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Entity Type | Organization
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Legal Business Name | MARTIN, WEDEL & BULLARD, P.C.
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 839 N NOLAN RIVER RD
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City | CLEBURNE
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State | TX
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Zip | 76033-7001
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Country | US
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Telephone | 817-645-2411
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Fax | 817-645-3447
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Provider Business Mailing Address
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Address Line | 839 N NOLAN RIVER RD
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City | CLEBURNE
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State | TX
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Zip | 76033-7001
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Country | US
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Telephone | 817-645-2411
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Fax | 817-645-3447
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Authorized Official
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Title or Position | OWNER
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Name | DR. HEATH L BULLARD
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Credential | O.D.
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Telephone | 817-645-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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