DR. DALE EUGENE FULLER MD NPI 1235159310

NPI Information

NPI: 1235159310
Provider Name: DR. DALE EUGENE FULLER, MD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

Address:
12221 MERIT DRIVE
#500
DALLAS, TX
ZIP 75251
Phone: (972) 490-2900
Get Directions

DR. Dale Eugene Fuller, MD is a radiation oncology radiology in Dallas, TX. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. DR. Dale Eugene Fuller, MD NPI is 1235159310. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12221 MERIT DRIVE
#500
DALLAS, TX
ZIP 75251
Phone: (972) 490-2900
Fax: (972) 386-0261

The enumeration date for this NPI number is 7/20/2006 and was last updated on 6/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0001X	Radiology	Radiation Oncology	D4659	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	139559207	MEDICAID	TEXAS
2	139559214	MEDICAID	TEXAS
3	88265K	MEDICARE PIN	TEXAS
4	139559201	MEDICAID	TEXAS
5	139559210	MEDICAID	TEXAS
6	139559202	MEDICAID	TEXAS
7	139559205	MEDICAID	TEXAS
8	920000101	MEDICARE PIN	TEXAS
9	139559208	MEDICAID	TEXAS
10	E18189	MEDICARE UPIN	TEXAS
11	139559212	MEDICAID	TEXAS
12	139559203	OTHER	TEXAS	CSHCN
13	139559204	MEDICAID	TEXAS
14	8R1441	OTHER	TEXAS	BLUE CROSS OF TX
15	139559206	MEDICAID	TEXAS
16	139559211	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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