Individual
DR. CLIFFORD T FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5345 N PRESIDENT GEORGE BUSH HWY, GARLAND, TX 75040-2767
(972) 495-5888
(972) 495-0588
Mailing address
5345 N GEORGE BUSH FWY, GARLAND, TX 75040-2767
(972) 495-5888
(972) 495-0588
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G5070
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080086243
RR MEDICARE
TX
05
—
116434502
—
TX
01
—
87W705
BCBS
TX
Enumeration date
07/03/2006
Last updated
07/29/2009
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