Individual
SAMANTHA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
16655 SOUTHWEST FWY, SUGAR LAND, TX 77479-2329
(281) 274-7000
Mailing address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(713) 363-8010
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
771348
TX
363LA2100X
Acute Care Nurse Practitioner
771348
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
771348
TX
Other
Enumeration date
03/17/2014
Last updated
12/07/2022
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