Provider Demographics
NPI:1396841383
Name:BULLOCK, EMILY CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:CLAIRE
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:CLAIRE
Other - Last Name:SOTELO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9200 PINECROFT DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3279
Mailing Address - Country:US
Mailing Address - Phone:281-602-6888
Mailing Address - Fax:281-292-5780
Practice Address - Street 1:9200 PINECROFT DR
Practice Address - Street 2:SUITE 400
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:281-602-6888
Practice Address - Fax:281-292-5780
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11111207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology