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

Travis Bulloch

Individual provider Emergency Medicine Physician · NPI 1265058853

Travis Bulloch is an Emergency Medicine in Columbia, Missouri. Graduated from University of Texas Southwestern Medical School at Dallas in 2020, 6 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Missouri.

Years since qualifying
6
Trained at
University of Texas Southwestern Medical School at Dallas
Licensed in
ID, MO
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

1 Hospital Dr Emergency Medicine M562 DC029.10
Columbia, MO 65212-0001
Phone: (573) 884-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 190 E Bannock St, Boise, ID 83712-6241 — (208) 381-2235

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 2020015720 (MO)
Emergency Medicine Physician Taxonomy 207P00000X · Licence M-17087 (ID)

Record details

NPI number1265058853
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 19, 2020
Last updated in NPPESApril 26, 2023
Certification dateApril 26, 2023
Mailing address1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated 2020 (6 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Columbia