Provider Demographics
NPI:1316204571
Name:BULGER AND RODRIGUE SOUTHWEST PAIN GROUP PLLC
Entity type:Organization
Organization Name:BULGER AND RODRIGUE SOUTHWEST PAIN GROUP PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:BULGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-265-9991
Mailing Address - Street 1:8230 WALNUT HILL LN
Mailing Address - Street 2:PROFESSIONAL BLDG. III, SUITE 320
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4482
Mailing Address - Country:US
Mailing Address - Phone:214-265-9991
Mailing Address - Fax:214-265-1457
Practice Address - Street 1:8230 WALNUT HILL LN
Practice Address - Street 2:PROFESSIONAL BLDG. III, SUITE 320
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4482
Practice Address - Country:US
Practice Address - Phone:214-265-9991
Practice Address - Fax:214-265-1457
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BULGER AND RODRIGUE SOUTHWEST PAIN GROUP PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207LP2900X, 363AM0700X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty