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NPI Code Detail

MEDICARE: SANDY FULLER INC.

MEDICARE: SANDY FULLER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center1118313TX

General Provider Information

NPI Number : 1851562094
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANDY FULLER INC.
Provider Business Mailing Address
First Line : 4801 WOODWAY DR
Second Line : SUITE 370W
City : HOUSTON
State : TX
Zip : 77056-1884
Country : US
Telephone Number : 713-622-7060
Fax Number : 713-622-7093
Provider Business Practice Location Address
First Line : 13319 MISTY MILL DR
Second Line :
City : HOUSTON
State : TX
Zip : 77041-5501
Country : US
Telephone Number : 832-368-5536
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. SANDRA FOGARTY FULLER
Credential : P.T.
Telephone Number : 832-368-5536
Provider Enumeration Date : 03/16/2008
Last Update Date : 03/16/2008

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Directions to “SANDY FULLER INC. ” Practice Location

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