Provider Demographics
NPI:1184769812
Name:BULLARD, TRICIA LOIS (MSN RN CPNP)
Entity type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:LOIS
Last Name:BULLARD
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Gender:F
Credentials:MSN RN CPNP
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Mailing Address - Street 1:1502 SADDLECREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2136
Mailing Address - Country:US
Mailing Address - Phone:281-397-0388
Mailing Address - Fax:281-397-0388
Practice Address - Street 1:490 IH 10 N STE 100
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1819
Practice Address - Country:US
Practice Address - Phone:409-212-9988
Practice Address - Fax:409-212-8449
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2018-05-16
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Provider Licenses
StateLicense IDTaxonomies
TXAP105033363LP0200X
TX256934363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics