DR. BRIAN C FULLER (NPI# 1396972386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396972386 |
Entity Type | Individual |
Full Name | DR. BRIAN C FULLER |
Credential | M.D. |
Practice Address |
4780 N Josey Ln Carrollton TX 75010-4615 |
Practice Telephone | 9724921334 |
Practice Fax Number | 9724927909 |
Mailing Telephone | 9724921334 |
Mailing Fax Number | 9724927909 |
Enumeration Date | 2009-06-17 |
Last Update Date | 2020-06-29 |
NPI Deactivation Date | 08/21/2019 |
NPI Reactivation Date | 2019-09-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgery | 25870 | NE | Allopathic & Osteopathic Physicians |
Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
R8564 | TX | Allopathic & Osteopathic Physicians |
N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
036144916 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | BCBS | 8LJ360 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
1650 Cochrane Cir, Fort Carson, CO 809134613 | 7095262092 | |
2535 Ira E Woods Ave, Grapevine, TX 76051 | 8174812121 | |
4501 Heritage Trace Pkwy Ste 101, Fort Worth, TX 762448940 | 8174812121 | 8174884493 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760674725 | Brian Scott Fuller | Dentist | 1920 S 1st St, 1509, Minneapolis, MN 55454-1055 | 2007-08-14 |
1316035280 | Brian Christopher Fuller | Pediatrics | 2401 Village Professional Drive, Opelika, AL 36801-4702 | 2006-10-10 |
1073556544 | Brian Jay Fuller | Chiropractor | 211 N Clinton St, Suite 2s, Chicago, IL 60661-1282 | 2006-06-13 |
1972562601 | Brian George Fuller | Physical Therapist | 15 Porters Glen Pl, Durham, NC 27713-9164 | 2006-03-21 |
1730174160 | Brian J Fuller | Physical Therapist | 4453 State Route 159, Chillicothe, OH 45601-8620 | 2005-09-12 |
1427540178 | Brian Fuller | Pediatrics | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2018-05-30 |
1184915365 | Brian Robert Fuller | Pharmacist | 105 Mall Blvd, Monroeville, PA 15146-2230 | 2011-04-22 |
1033409438 | Brian Edward Fuller | Psychiatry & Neurology | 6107 Pinewood Rd, Nunnelly, TN 37137-2523 | 2011-04-19 |
1780973982 | Brian J Fuller | Family Medicine | 6909 Good Samaritan Dr, Suite A, Cincinnati, OH 45247-5208 | 2011-03-29 |
1336473032 | Brian K Fuller | Case Manager/Care Coordinator | 3211 Jefferson St, San Diego, CA 92110-4424 | 2009-09-28 |
Street Address |
4780 N JOSEY LN |
City | CARROLLTON |
State | TX |
Zip Code | 75010-4615 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780683490 | Metrocrest Surgery Center Lp | Clinic/Center | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2005-07-15 |
1265998728 | Carrollton Or Surgical Affiliates Pllc | Physician Assistant | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2019-02-20 |
1952874257 | West Plano Surgery Specialist Pllc | Physician Assistant | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2019-01-09 |
1861969511 | Megan Elizabeth Carter | Physician Assistant | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2018-10-31 |
1760965842 | Holly Valle | Specialist/Technologist, Other | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2018-09-13 |
1366961104 | Julianne Joy Kucera | Physician Assistant | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2017-09-13 |
1013305945 | North Star Cn, Lp | Clinic/Center | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2014-12-30 |
1598106775 | Orthopedic Partners for Surgical Advancement | Physician Assistant | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2013-07-16 |
1013354307 | John Arvesen | Orthopaedic Surgery | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2013-05-28 |
1538409248 | Chelsea Michelle Bardwell | Physical Therapist | 4780 N Josey Ln, Carrollton, TX 75010-4615 | 2013-02-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043782907 | Timothy C. Pringle Md Pa | Surgery | 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 | 2018-12-17 |
1184106411 | Cindy T Vu | Occupational Therapy Assistant | 1877 Cheyenne, Carrollton, TX 75010 | 2018-09-04 |
1639686256 | Little Lantern Hospice LLC | Hospice Care, Community Based | 4541 North Josey Lane, Suite 110-b, Carrollton, TX 75010 | 2018-01-04 |
1235681610 | Kahini Shah | Physical Therapist | 1012 W Hebron Pkwy Ste 124, Carrollton, TX 75010 | 2016-11-01 |
1881148849 | Wais Azesh | Dentist | 1233 Apache Lake Dr, Carrollton, TX 75010 | 2016-08-08 |
1225485055 | Julia Buckelew | Physical Therapist | 4100 Fairway Dr Ste 400, Carrollton, TX 75010 | 2016-05-23 |
1811355639 | Fastpass Ucc, Pllc | Clinic/Center | 4228 N Josey Ln Ste 150, Carrollton, TX 75010 | 2016-02-08 |
1326404393 | Miaojuan Li | Nurse Practitioner | 4100 Fairway Dr Ste 300, Carrollton, TX 75010 | 2016-01-06 |
1912376112 | Envoy Hospice North LLC | Hospice Care, Community Based | 4040 Tx-121, Carrollton, TX 75010 | 2015-09-17 |
1932593936 | Lifeway Hospice, LLC | Hospice Care, Community Based | 4040 State Highway 121, Suite 140, Carrollton, TX 75010 | 2015-03-27 |
Find all providers in zip 75010 |
Taxonomy Code | 207XS0114X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Adult Reconstructive Orthopaedic Surgery |
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598108797 | Bone and Joint Surgery Associates, P.a. | Orthopaedic Surgery | 2122 Babcock Rd Ste 101, San Antonio, TX 78229-4411 | 2013-04-08 |
1578846002 | David Peter Brigati | Orthopaedic Surgery | Health Transformation Building, 1601 Trinity Street, Austin, TX 78712 | 2011-09-21 |
1831496983 | Gens Pierce Goodman | Orthopaedic Surgery | 4801 Alberta Ave Ste 101, Orthopaedic Surgery, El Paso, TX 79905-2707 | 2011-02-24 |
1699920256 | Vijayaraj Kannan | Orthopaedic Surgery | 6550 Fannin Street Suite 2500, The Methodist Hospital,center for Orthopaedic Surgery, Houston, TX 77030 | 2008-11-24 |
1023260478 | Jesse James Ferraris Exaltacion | Orthopaedic Surgery | 6550 Fannin St., Suite 2500 The Methodist Hospital, Center for Orthopaed, Houston, TX 77030 | 2008-10-16 |
1043483134 | Michael C Cusick | Orthopaedic Surgery | 601 Rockmead Dr Ste 100, Kingwood, TX 77339-2107 | 2008-04-09 |
1972787927 | Farbod Malek | Orthopaedic Surgery | 2122 Babcock Rd, Suite 101, San Antonio, TX 78229-4411 | 2007-12-27 |
1003018086 | Mario Joseph Quesada | Orthopaedic Surgery | 1201 E Alton Gloor Blvd, Suite B, Brownsville, TX 78526-3831 | 2007-06-01 |
1750400636 | Louise Marie Brooker | Orthopaedic Surgery | 4514 Cornell St, Suite B, Amarillo, TX 79109-5800 | 2007-03-29 |
1457429375 | The San Antonio Orthopaedic Group, LLP | Orthopaedic Surgery | 19138 Us Highway 281 N Ste 100, San Antonio, TX 78258-4988 | 2006-11-30 |
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City | CARROLLTON |
Zip Code | 75010 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.