Individual
DANIEL W FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC. LAT.
Contact information
Practice address
3414 GOLDEN RD, TYLER, TX 75701-8336
(903) 939-7500
(903) 597-1245
Mailing address
447 REDBUD CIR, WHITEHOUSE, TX 75791-4405
(903) 871-2634
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT1427
TX
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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