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:
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Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780680439 NPPES
Texas MEDICAID 140117607
Texas MEDICAID 140117624
Texas Other 113131101

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