Desiree Bullock
Individual provider Active NPI Home Health Agency · Alvin, TX
NPI 1932860145 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1932860145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Agency 251E00000X
- Practice address
- 1223 Quarterhorse Dr
Alvin, TX 77511-1784 - Phone
- (513) 388-1500
- NPI assigned
- Jan 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
1223 Quarterhorse Dr
Alvin, TX 77511-1784
Mailing address
1223 Quarterhorse Dr
Alvin, TX 77511-1784
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3121302 | Medicaid | OH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | DBULLOCK0801@GMAIL.COM |
Other providers in Alvin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.