Provider Demographics
NPI:1437157047
Name:MARTIN, WEDEL & BULLARD, P.C.
Entity type:Organization
Organization Name:MARTIN, WEDEL & BULLARD, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-645-2411
Mailing Address - Street 1:839 N NOLAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7001
Mailing Address - Country:US
Mailing Address - Phone:817-645-2411
Mailing Address - Fax:817-645-3447
Practice Address - Street 1:4460 E HIGHWAY 287 STE A
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-7031
Practice Address - Country:US
Practice Address - Phone:972-775-8000
Practice Address - Fax:972-775-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80286QOtherBLUE CROSS BLUE SHIELD
TX0065DGOtherBLUE CROSS BLUE SHIELD
TX80182QOtherBLUE CROSS BLUE SHIELD
TX80183QOtherBLUE CROSS BLUE SHIELD
TX81036QOtherBLUE CROSS BLUE SHIELD
TX410038705Medicare PIN
TX0065DGOtherBLUE CROSS BLUE SHIELD
TX81036QOtherBLUE CROSS BLUE SHIELD
TX8B7501Medicare PIN
TX88140KMedicare PIN
TXP00135354Medicare PIN
TX80286QOtherBLUE CROSS BLUE SHIELD
TX88144KMedicare PIN
TX410039048Medicare PIN
TX410045187Medicare PIN