Individual provider Active NPI

Samantha Bullock, AGACNP

  • Adult Health Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1992121792
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
771348 Issued in TX
Practice address
16655 Southwest Fwy
Sugar Land, TX 77479-2329
Phone
(281) 274-7000
NPI assigned
Mar 17, 2014
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 771348 TX
Adult Health Nurse Practitioner 363LA2200X 771348 TX Primary
Registered Nurse 163W00000X 771348 TX

Addresses

Primary practice location

16655 Southwest Fwy
Sugar Land, TX 77479-2329

Mailing address

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 363-8010

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Sabullock@houstonmethodist.org
CONNECT URL Sabullock@houstonmethodist.org Direct

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220705002472 TX Practitioner - Nurse Practitioner 5294115531 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians
Houston Methodist Specialty PhysiciansGroup PAC ID 5193239796, 1,498 clinicians

Practice addresses (Care Compare)

16605 Southwest Fwy
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 Southwest Fwy 400 Mob3
Methodist Family Medicine Group
Sugar Land, TX 77479-3500
Phone (281) 275-0800

16605 SW Fwy 410
Methodist Diag Card of Houston
Sugar Land, TX 77479-3500
Phone (281) 274-0148

16655 Southwest Fwy
Sugar Land, TX 77479-2329

16811 Southwest Fwy
Suite 200
Sugar Land, TX 77479-4728
Phone (281) 690-4678

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
771348TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince May 9, 2022 Accepting new patients
TMH Physician Associates PLLC CurrentSince May 9, 2022 Accepting new patients
Houston Methodist Specialty Physicians CurrentSince Jan 1, 2026 Accepting new patients
Methodist Radiology Associates, PLLC Past Accepting new patients

Locations

6565 Fannin St
#623
Houston, TX 77030
Phone (713) 363-8584

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

16655 Southwest Fwy
Sugar Land, TX 77479
Phone (281) 274-7117

16811 Southwest Fwy
Ste 200
Sugar Land, TX 77479
Phone (281) 690-4678

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Interoperability endpoints

  • Direct secure messaging: sbullock36737@directhoustonmethodist.org

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1992121792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302703",
            "telephone_number": "713-363-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16655 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792329",
            "telephone_number": "281-274-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "SAMANTHA",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "771348",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "771348",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "771348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Sabullock@houstonmethodist.org",
            "affiliation": "N",
            "address_1": "16655 Southwest Fwy",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774792329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Sabullock@houstonmethodist.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16655 Southwest Fwy",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774792329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.