Clinton Lee Fuller

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

BP10042968 Issued in TX

Practice address

6621 Fannin St Ste A3300
Houston, TX 77030

Phone

(832) 824-1000

NPI assigned

Apr 26, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Anesthesiology

Education

University of Texas Medical School at Houston, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment Care Compare group NPD
• Baylor College of Medicine

  • Neurological Surgery Physician
  • Houston, TX
  • NPI 1730132721
  NPD (past)

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1104184191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE A3300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE A3300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1709 Dryden Rd",
            "address_2": "Ste 1700",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302400",
            "country_code": "US",
            "telephone_number": "713-798-7356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1709 Dryden Rd",
            "address_2": "Ste 1700",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302400",
            "country_code": "US",
            "telephone_number": "713-798-7356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CLINTON",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "BP10042968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Fullbright, MS, BCBA
• Kristin Fullen
• Alexis Fuller
• Arian Fuller
• Clifton David Fuller, MD
• Gayle Lynn Fuller, M.ED., LPC
• Gladys Fuller
• Gregory N. Fuller, M.D. PHD
• Lisa Fuller, MD
• Maren Yngve Fuller, M.D.

• Anesthesiology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.