MEDICARE: DR. BRIDGETTE PULLIS PHD

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	163WH1000X	Hospice Registered Nurse	557155	TX

General Provider Information

NPI Number	:	1063852366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIDGETTE PULLIS PHD

Provider Business Mailing Address
First Line	:	2730 HOLLY HALL ST
Second Line	:	APT I
City	:	HOUSTON
State	:	TX
Zip	:	77054-4212
Country	:	US
Telephone Number	:	713-500-2189
Fax Number	:	713-500-2142

Provider Business Practice Location Address
First Line	:	6901 BERTNER AVE
Second Line	:	SUITE 729
City	:	HOUSTON
State	:	TX
Zip	:	77030-3901
Country	:	US
Telephone Number	:	713-500-2189
Fax Number	:	713-500-2142

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

Provider Enumeration Date	:	07/01/2013
Last Update Date	:	07/01/2013

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