Fullerton, Bradley Dean

Fullerton, Bradley Dean is an sole proprietor health care provider with primary practice located at 2714 Bee Caves Rd Suite 106, Austin TX 78746-5677. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Fullerton, Bradley Dean can be contacted via phone (512) 347-7246.

Contact Information

Primary practice address
2714 Bee Caves Rd Suite 106 Austin TX 78746-5677
Phone: (512) 347-7246
Fax: (512) 347-7245
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X K3731 Texas

Profile Details

NPI number 1568463487
LBN Legal business name Fullerton, Bradley Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2005
Last updated Aug 24th, 2015 - about 9 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 1568463487 NPPES
Texas MEDICAID 110711203

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