Individual
ALLIE MARIE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6684 W ADAMS AVE, TEMPLE, TX 76502-5632
(254) 899-4200
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N5681
TX
208M00000X
Hospitalist Physician
N5681
TX
Other
Enumeration date
06/18/2008
Last updated
12/08/2021
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