SHELLY LAREE BULLOCK
NPI 1609677707
Nurse Practitioner - Family in Bay City, TX
About Shelly Laree Bullock NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHELLY LAREE BULLOCK (NPI 1609677707) is an individual family provider in Bay City, Texas, licensed in Texas (1193041) and active in the NPI registry since March 2025. She is a graduate of University Of Texas Medical Branch At Galveston (2024).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shelly Laree Bullock is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shelly Bullock's NPI number?
The NPI number for Shelly Bullock is 1609677707. It was assigned to this individual provider in the NPPES registry on March 24, 2025.
Where is Shelly Bullock located?
Shelly Bullock practices at 1120 Avenue G, Bay City, TX 77414. The listed phone number is (979) 245-5721.
What is Shelly Bullock's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shelly Bullock enrolled in Medicare?
Yes. Shelly Bullock is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Shelly Bullock was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shelly Laree Bullock · NPI 1609677707
Family physician in Bay City, Texas. Individual provider, active in the CMS NPPES registry since March 24, 2025.
## Identity
- **NPI:** 1609677707 (Entity type: Individual)
- **Enumerated:** March 24, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1193041 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1120 AVENUE G, Bay City, TX 77414-3541
- **Phone:** (979) 245-5721 · **Fax:** (979) 245-1482
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medical school:** University Of Texas Medical Branch At Galveston, class of 2024
## Record status
- **NPPES last updated:** June 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1609677707) · Data from the CMS NPPES public registry.