Individual
CLINTON LEE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6621 FANNIN ST STE A3300, HOUSTON, TX 77030
(832) 824-1000
Mailing address
6621 FANNIN ST STE A3300, HOUSTON, TX 77030-2373
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
BP10042968
TX
Other
Enumeration date
04/26/2012
Last updated
11/05/2018
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