Individual
GREGORY N. FULLER
Active
Individual
GREGORY N. FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. PHD
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
H4335
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220009629
RR MEDICARE
TX
05
—
41267801
—
TX
01
—
82M056
BCBS
TX
Enumeration date
09/14/2006
Last updated
07/05/2012
Update your record
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