Individual provider Active NPI

Stephanie Rose Fuller, D.O.

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1013234244
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P0584 Issued in TX
Practice address
10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone
(682) 212-2300
NPI assigned
Apr 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X P0584 TX Primary

Addresses

Primary practice location

10864 Texas Health TRL
Fort Worth, TX 76244-4897

Mailing address

4055 International PLZ Ste 230
Fort Worth, TX 76109-4874
Phone (817) 496-9700

Other identifiers 2

IdentifierTypeStateIssuer
P0584OtherTXTEXAS MEDICAL BOARD
H0182969OtherTXDPS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210002049 TX Practitioner - Emergency Medicine 7214164649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

10864 Texas Health TRL
Fort Worth, TX 76244-4897
Phone (682) 212-2000

Hospital & facility affiliations

  • Texas Health Harris Methodist Hospital Alliance Hospital, Fort Worth, TX, CCN 670085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

108 Denver Trl
Azle, TX 76020
Phone (817) 444-8600

2750 SW Wilshire Blvd
Burleson, TX 76028
Phone (817) 782-8000

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

10864 Texas Health Trl
Fort Worth, TX 76244
Phone (682) 212-2000

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

6451 Brentwood Stair Rd
Ste 200
Ft Worth, TX 76112
Phone (817) 496-9700

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1013234244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 INTERNATIONAL PLZ STE 230",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094874",
            "telephone_number": "817-496-9700",
            "fax_number": "817-507-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10864 TEXAS HEALTH TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444897",
            "telephone_number": "682-212-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P0584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "P0584",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "H0182969",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.