Individual
ANTHONY RAYMOND FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8200
Mailing address
1122 BALLARD GREEN PL, BRANDON, FL 33511-2390
(806) 790-5329
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP140202
TX
Other
Enumeration date
12/18/2018
Last updated
01/07/2022
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