Individual
DR. BRIAN C FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 492-1334
(972) 492-7909
Mailing address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 492-1334
(972) 492-7909
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25870
NE
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
036144916
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
R8564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8LJ360
BCBS
TX
Enumeration date
06/17/2009
Last updated
06/29/2020
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