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Individual
PAT FOX FULGHAM
Active
Individual
PAT FOX FULGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
F9454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125757801
—
TX
05
—
125757802
—
TX
01
—
340016187
RRMCR OTHER
TX
01
—
80402X
BCBS PROVIDER ID
—
01
—
P00303398
RRMCR
TX
Enumeration date
05/19/2006
Last updated
01/31/2017
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