Individual provider Active NPI

Heath L Bullard, O.D.

  • Optometrist
  • Cleburne, TX
National Provider Identifier
1174521769
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5894 Issued in TX
Practice address
839 N Nolan River Rd
Cleburne, TX 76033-7001
Phone
(817) 645-2411
Fax
(817) 645-2189
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5894 TX Primary
Optometrist 152W00000X 5894TG TX

Addresses

Primary practice location

839 N Nolan River Rd
Cleburne, TX 76033-7001

Mailing address

839 N Nolan River Rd
Cleburne, TX 76033-7001
Phone (817) 645-2411

Other identifiers 3

IdentifierTypeStateIssuer
0463648-01MedicaidTX
23910OtherTXOPTICARE
80286QOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000687 TX Practitioner - Optometry 9739212127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

4460 E Hwy 287
Suite a
Midlothian, TX 76065-7031
Phone (972) 775-8000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5894TXMDBehavioral Analyst
5894TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin, Wedel & Bullard, P.C. Optometrist CurrentSince Jul 24, 2000 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Apr 2, 2024 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist CurrentSince Jul 24, 2000 Accepting new patients
Dianne Bui Dao OD PC Optometrist PastSince Apr 24, 2011 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist Past Accepting new patients
Pope Enterprises PLLC Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

209 Market St
Burleson, TX 76028
Phone (817) 295-0186

110 W Henderson St
Cleburne, TX 76033
Phone (817) 645-2411

839 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 645-2411

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

1102 S Friendswood Dr
Ste A
Friendswood, TX 77546
Phone (281) 482-0066

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

4460 E Highway 287
Ste A
Midlothian, TX 76065
Phone (972) 775-8000

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1174521769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 N NOLAN RIVER RD",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337001",
            "telephone_number": "817-645-2411",
            "fax_number": "817-645-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 N NOLAN RIVER RD",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337001",
            "telephone_number": "817-645-2411",
            "fax_number": "817-645-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "HEATH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5894",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5894TG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463648-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE",
            "identifier": "23910",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80286Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.