Individual
DR. MICHAEL GLENN BULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 ELIZABETH ST, CORPUS CHRISTI, TX 78404-2235
(361) 887-5575
(361) 854-2480
Mailing address
654 MORAY PL, CORPUS CHRISTI, TX 78411-1925
(361) 887-5575
(361) 854-2480
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
F8813
TX
207RI0200X
Infectious Disease Physician
Primary
F8813
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11568402
—
TX
Enumeration date
01/23/2007
Last updated
06/28/2011
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