Shelly Laree Bullock

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1193041 Issued in TX

Practice address

1120 Avenue G
Bay City, TX 77414-3541

Phone

(979) 245-5721

Fax

(979) 245-1482

NPI assigned

Mar 24, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Nurse Practitioner

Education

University of Texas Medical Branch at Galveston, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1609677707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 AVENUE G",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143545",
            "telephone_number": "979-245-5721",
            "fax_number": "979-245-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 AVENUE G",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143541",
            "telephone_number": "979-245-5721",
            "fax_number": "979-245-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "SHELLY",
        "middle_name": "LAREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1193041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Home Health of Lufkin LP
• Robert Oscar Boysen
• Aaron Bridwell, D.C.
• Earl Stanley Brown, OD
• Rhonda Vinson Brown, FNP
• Carol O Butler
• Julie Bynum, PHARM D
• Sandi Lynn Bystrek, OT
• Nicolas Castro Pinzon
• Irina Catanescu, DO

• Family Nurse Practitioner in Bay City, TX
• Providers in Bay City, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.