Individual
TERRY WAYNE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 PEASE ST STE 2C, HARLINGEN, TX 78550-8321
(956) 440-7494
(956) 440-8301
Mailing address
2121 PEASE ST STE 2C, HARLINGEN, TX 78550-8321
(956) 440-7494
(956) 440-8301
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
K0759
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000U84V
—
TX
Enumeration date
08/08/2006
Last updated
07/08/2007
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