Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Travis L Bullock, MD

Individual provider Urology Physician · NPI 1699810507

Mr. Travis L Bullock, MD is an Urology in Saint Louis, Missouri. Graduated from Eastern Virginia Medical School in 2002, 24 years ago. Practices with Urology of St Louis Inc, a 111-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Missouri.

Years since qualifying
24
Trained at
Eastern Virginia Medical School
Licensed in
IL, MO
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12855 N 40 Dr Ste 350
Saint Louis, MO 63141-8669
Phone: (314) 567-6071
Fax: (314) 567-3321
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 6812 State Route 162 Ste 200, Maryville, IL 62062-8562 — (618) 288-0900
  • 111 Saint Lukes Center Dr Ste 40, Chesterfield, MO 63017-3509 — (314) 567-6071

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 036119508 (IL)
Urology Physician Taxonomy 208800000X · Licence 2007030776 (MO)

Record details

NPI number1699810507
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 20, 2007
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2002 (24 years in practice)
Group practice Urology Of St Louis Inc — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Saint Louis