Individual
JEFF BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 E EUCLID AVE, SAN ANTONIO, TX 78212-4414
(210) 271-0606
Mailing address
520 E EUCLID AVE, SAN ANTONIO, TX 78212-4414
(210) 271-0606
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
K7135
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RM40
MEDICARE
TX
05
—
147650902
—
TX
Enumeration date
06/10/2005
Last updated
06/21/2010
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