Individual
MR. BILLY CARL FULLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
13915 MOPAC SERVICE RD, #200, AUSTIN, TX 78728
(336) 608-2715
Mailing address
1007 MEADOW OAK DR, GREENSBORO, NC 27406-8284
(336) 608-2715
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13851
NC
235Z00000X
Speech-Language Pathologist
2202009409
VA
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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