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Individual
DR. DONALD RAY FULSOM
Active
Individual
DR. DONALD RAY FULSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
L6047
TX
2084P0804X
Child & Adolescent Psychiatry Physician
L6047
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158042501
—
TX
Enumeration date
09/14/2005
Last updated
05/14/2025
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