Provider Demographics
NPI:1447495973
Name:BULAN, ALEXANDER (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:BULAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 RAINTREE CIR STE 150
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4954
Mailing Address - Country:US
Mailing Address - Phone:469-342-3383
Mailing Address - Fax:
Practice Address - Street 1:997 RAINTREE CIR STE 150
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4954
Practice Address - Country:US
Practice Address - Phone:469-342-3383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA136644363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant