Individual
ROB ALAN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3705 MEDICAL PKWY, SUITE 250, AUSTIN, TX 78705-1019
(512) 302-1210
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
J9581
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144659303
—
TX
05
—
144659304
—
TX
01
—
P01768707
RAILROAD
TX
Enumeration date
01/11/2006
Last updated
04/10/2017
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