Individual
AMANDA BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
810 BUCKEYE PL, MISSOURI CITY, TX 77459-5716
(713) 483-4119
Mailing address
810 BUCKEYE PL, MISSOURI CITY, TX 77459-5716
(713) 483-4119
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84780
TX
Other
Enumeration date
06/05/2020
Last updated
06/05/2020
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