# CENTER FOR ORTHOPEDIC MEDICINE, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588863278
- **Authorized official:** DR. KENNETH L FULTS D.O. (PRESIDENT)
- **Authorized official phone:** (903) 526-5000

## Contact information

- **Practice address:** 11600 JONES RD, SUITE 108-5, HOUSTON, TX 77070-5929
- **Practice address phone:** (713) 981-1522
- **Practice address fax:** (713) 981-9038
- **Mailing address:** 223 E 5TH ST, TYLER, TX 75701-4224
- **Mailing address phone:** (903) 526-5000
- **Mailing address fax:** (903) 526-5006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | D5384 | TX | Yes |

## Other

- **Enumeration date:** 07/13/2007
- **Last updated:** 07/13/2007