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Organization
PROASSIST
Active
Organization
PROASSIST
Active
Other names
Michael W Fuller PA
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W FULLER PA (PRESIDENT)
(214) 378-9898
Entity
Organization
Contact information
Practice address
7777 FOREST LN, MEDICAL CITY DALLAS, DALLAS, TX 75230
(972) 566-7000
Mailing address
PO BOX 670039, DALLAS, TX 75367-0039
(214) 378-9898
(214) 378-9888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02147
TX
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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