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NPI Code Detail

MEDICARE: NYASHA ONIKA BULLOCK M.D.

MEDICARE: NYASHA ONIKA BULLOCK M.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
1207ZC0500XCytopathology Physician10604AWY
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician10604AWY
3207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianU3080TX

General Provider Information

NPI Number : 1932337631
Entity Type Code : Individual
Provider Name (Legal Business Name) : NYASHA ONIKA BULLOCK M.D.
Provider Business Mailing Address
First Line : 4131 DIRECTORS ROW
Second Line :
City : HOUSTON
State : TX
Zip : 77092-8703
Country : US
Telephone Number : 877-697-2447
Fax Number : 855-697-2447
Provider Business Practice Location Address
First Line : 4131 DIRECTORS ROW
Second Line :
City : HOUSTON
State : TX
Zip : 77092-8703
Country : US
Telephone Number : 877-697-2447
Fax Number : 855-697-2447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2009
Last Update Date : 05/04/2026

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