Individual
MAREN YNGVE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6621 FANNIN ST, HOUSTON, TX 77030-2358
(832) 824-6422
(832) 825-0164
Mailing address
6565 FANNIN ST, MGJ9-002, HOUSTON, TX 77030-2703
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
BP10044080
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
Q7872
TX
Other
Enumeration date
05/31/2012
Last updated
07/10/2019
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