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Individual

CHRIS FILLERUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-3431
(817) 927-3603
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-2450
(817) 702-8445

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015091
NY
363A00000X
Physician Assistant
10004808A
IN
363A00000X
Physician Assistant
Primary
PA09671
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03436853
NY
Enumeration date
09/22/2011
Last updated
07/15/2025
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