Individual
ZACHARY D. FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
(210) 567-6418
Mailing address
7703 FLOYD CURL DR # MC7977, SAN ANTONIO, TX 78229-3901
(210) 358-4000
(210) 567-6418
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
R4697
TX
2085R0202X
Diagnostic Radiology Physician
R4697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411950501
—
TX
01
—
411950502
CSHCN
TX
Enumeration date
06/02/2014
Last updated
07/24/2020
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