Fuller, Charles W
Fuller, Charles W is an sole proprietor health care provider with primary practice located at 1933 Pine St Ste B, Abilene TX 79601-2431. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Fuller, Charles W can be contacted via phone (325) 675-0338.Contact Information
Primary practice address
1933 Pine St Ste B
Abilene TX 79601-2431
Phone: (325) 675-0338
Fax: (325) 676-5049
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | F3971 | Texas |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | F3971 | Texas |
Profile Details
| NPI number | 1780680439 |
|---|---|
| LBN Legal business name | Fuller, Charles W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Aug 4th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780680439 | NPPES |
| Texas | MEDICAID | 140117607 | |
| Texas | MEDICAID | 140117624 | |
| Texas | Other | 113131101 |
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