Search › Missouri › 208800000X
Travis Bullock, MD
NPI 1699810507 · on the registry since 2007
Practice
- Address
- 12855 N 40 Dr Ste 350
Saint Louis, MO 63141 - Phone
- (314) 567-6071
- Fax
- (314) 567-3321
- Organisation at this address
- Prorehab Pc
Advanced Labs, Llc
Gomelb Vascular Llc
St Louis Kidney, Llc
Steven Frank Dpm LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 72
Additional practice sites
- 111 Saint Lukes Center Dr Ste 40, Chesterfield, MO
- 6812 State Route 162 Ste 200, Maryville, IL
Registry record
- Primary taxonomy
- 208800000X
208800000X
- Also registered as
- 208800000X
- Licence states on file
- MO, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-08-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri