Healthcare Provider Details

I. General information

NPI: 1720992613
Provider Name (Legal Business Name): BRYCE FULTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 GIBBONS RD S
ARGYLE TX
76226-6321
US

IV. Provider business mailing address

511 GIBBONS RD S
ARGYLE TX
76226-6321
US

V. Phone/Fax

Practice location:
  • Phone: 940-464-7102
  • Fax:
Mailing address:
  • Phone: 940-464-7102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number785821
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: