MEDICARE: DR. REX WARREN BULL PH.D.

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	103TC0700X	Clinical Psychologist	R0321	MO

General Provider Information

NPI Number	:	1013995075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REX WARREN BULL PH.D.

Provider Business Mailing Address
First Line	:	30 W WINTHROPE RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2432
Country	:	US
Telephone Number	:	816-523-8014
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 GARFIELD AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64124-1514
Country	:	US
Telephone Number	:	816-404-6346
Fax Number	:	816-404-6347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	07/08/2007

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