Shadrick Bullock

NPI #1235025958 in Owasso, Oklahoma

Provider Information

NPI Number: 1235025958
Entity Type: Individual
Name: Shadrick Bullock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Jun 17, 2025
Last Updated: Jun 17, 2025

Practice Location

Address: 8344 N 117TH EAST AVE
City: Owasso
State: Oklahoma
ZIP Code: 74055-2136
Phone: (918) 841-3794

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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