Individual
TARA FULBRIGHT LECROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6630 COLLEYVILLE BLVD, COLLEYVILLE, TX 76034-6272
(817) 424-3774
(817) 424-3398
Mailing address
6630 COLLEYVILLE BLVD, COLLEYVILLE, TX 76034-6272
(817) 424-3774
(817) 424-3398
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
K5296
TX
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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