Individual provider Active NPI

Tricia Lois Bullard, MSN RN CPNP

  • Pediatric Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1184769812
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP105033 Issued in TX
Practice address
490 Ih 10 N Ste 100
Beaumont, TX 77702-1819
Phone
(409) 212-9988
Fax
(409) 212-8449
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP105033 TX Primary
Pediatric Nurse Practitioner 363LP0200X 256934 TX

Addresses

Primary practice location

490 Ih 10 N Ste 100
Beaumont, TX 77702-1819

Mailing address

1502 Saddlecreek Dr
Houston, TX 77090-2136
Phone (281) 397-0388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
256934TXMDPediatric Nurse Practitioner
AP105033TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Topcare Medical Group Inc PastSince May 9, 2020 Accepting new patients
Best Care Pediatrics Past Accepting new patients

Organizations & group practices 2

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1184769812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 SADDLECREEK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902136",
            "telephone_number": "281-397-0388",
            "fax_number": "281-397-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 IH 10 N STE 100",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021819",
            "telephone_number": "409-212-9988",
            "fax_number": "409-212-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "TRICIA",
        "middle_name": "LOIS",
        "name_prefix": "Ms.",
        "credential": "MSN RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP105033",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "256934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.