Bullock, Mark Richmond
Bullock, Mark Richmond is an individual health care provider with primary practice located at 1034 N Willis St , Abilene TX 79603-4622. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Bullock, Mark Richmond can be contacted via phone (325) 673-8164.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0022775 | Texas |
Profile Details
| NPI number | 1962419697 |
|---|---|
| LBN Legal business name | Bullock, Mark Richmond |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Apr 4th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962419697 | NPPES |
| Texas | MEDICAID | 2831067 | |
| Texas | Other | 0022775 |
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