Individual
GERALD F BULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 W COLORADO BLVD, PAVILION 2 - SUITE 545, DALLAS, TX 75208-2363
(214) 941-9100
(214) 941-1949
Mailing address
221 W COLORADO BLVD, PAVILION 2 - SUITE 545, DALLAS, TX 75208-2363
(214) 941-9100
(214) 941-1949
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G1343
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00TT84
BC/BS
TX
05
—
123334803
—
TX
Enumeration date
06/14/2006
Last updated
03/07/2022
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