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General NPI Number Information
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NPI Number | 1396841383
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Entity Type | Individual
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Provider Name | EMILY CLAIRE BULLOCK MD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 9200 PINECROFT DR SUITE 400
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City | SHENANDOAH
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State | TX
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Zip | 77380-3279
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Country | US
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Telephone | 281-602-6888
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Fax | 281-292-5780
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Provider Business Mailing Address
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Address Line | 9200 PINECROFT DR SUITE 400
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City | SHENANDOAH
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State | TX
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Zip | 77380-3279
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Country | US
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Telephone | 281-602-6888
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Fax | 281-292-5780
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 11111
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License Number State | TX
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