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Organization
CENTER FOR ORTHOPEDIC MEDICINE, P.A.
Active
Organization
CENTER FOR ORTHOPEDIC MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH L FULTS D.O. (PRESIDENT)
(903) 526-5000
Entity
Organization
Contact information
Practice address
11600 JONES RD, SUITE 108-5, HOUSTON, TX 77070-5929
(713) 981-1522
(713) 981-9038
Mailing address
223 E 5TH ST, TYLER, TX 75701-4224
(903) 526-5000
(903) 526-5006
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
D5384
TX
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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