| NPI | 1730256074 |
|---|---|
| Other Name | MICHAEL W FULLER PA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W FULLER President 214-378-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA02147) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |