Active NPI
June Williams Fuller
- Prosthetics Case Management
- Humble, TX
National Provider Identifier
1013555739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 670251
- Practice address
- 15703 Cairnwell Bend Dr
Humble, TX 77346-4361 - Phone
- (832) 264-5293
- NPI assigned
- Dec 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Prosthetics Case Management | 1744P3200X | 670251 | TX | Primary |
Addresses
Primary practice location
15703 Cairnwell Bend Dr
Humble, TX 77346-4361
Mailing address
PO Box 2063
Humble, TX 77347-2063
Phone (832) 264-5293
Other practice location 1
16770 Imperial Valley Dr Ste 125E
Houston, TX 77060-3427
Phone (832) 264-5293
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | JFULL.Beauty@gmail.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 670251 | TX | MD | Prosthetics Case Management |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strategic Development & Instruction | Mental Health | Current | Accepting new patients |
| Strategic Development & Instruction | Current | Accepting new patients | |
| Sagacious Beauty LLC. | Mental Health | Current | Accepting new patients |
Locations
16770 Imperial Valley Dr
Ste 125E
Houston, TX 77060
Phone (713) 240-3946
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Humble, TX
- NPI 1306494687
Mental Health
-
- Case Manager/Care Coordinator
- Houston, TX
- NPI 1427708205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1013555739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2063",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773472063",
"telephone_number": "832-264-5293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15703 CAIRNWELL BEND DR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773464361",
"telephone_number": "832-264-5293"
}
],
"practiceLocations": [
{
"address_1": "16770 Imperial Valley Dr Ste 125E",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770603427",
"country_code": "US",
"telephone_number": "832-264-5293",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FULLER",
"first_name": "JUNE",
"middle_name": "WILLIAMS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-12",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "TX",
"license": "670251",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "JFULL.Beauty@gmail.com",
"affiliation": "N",
"address_1": "16843 Ellicott Rock Dr",
"city": "Humble",
"state": "TX",
"country_code": "US",
"postal_code": "773464206",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.