Provider Demographics
NPI:1649279738
Name:BULLITT, BRIAN ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:BULLITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7151 PRESTON RD
Mailing Address - Street 2:SUITE 111A
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5822
Mailing Address - Country:US
Mailing Address - Phone:214-387-4321
Mailing Address - Fax:214-387-4320
Practice Address - Street 1:7151 PRESTON RD
Practice Address - Street 2:SUITE 111A
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5822
Practice Address - Country:US
Practice Address - Phone:214-387-4321
Practice Address - Fax:214-387-4320
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2007-11-02
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
TX8602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU97321Medicare UPIN
TX8B2297Medicare PIN