Dwain Fuller, M.D. .

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D3227 Issued in TX

Practice address

9600 N. Central Expressway
Suite 100
Dallas, TX 75231-5078

Phone

(214) 692-6941

NPI assigned

Jul 18, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ophthalmic Partners, PA

  • Ophthalmology Physician
  • Desoto, TX
  • NPI 1245336718
  NPD (past)
• Ophthalmic Partners, PA

  • Ophthalmology Physician
  • Granbury, TX
  • NPI 1568541712
  NPD (past)
• Sweeney Eye Associates, PLLC

  • Specialist
  • Sunnyvale, TX
  • NPI 1164445201
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1184623639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650037",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650037",
            "telephone_number": "214-696-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 N. CENTRAL EXPRESSWAY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315078",
            "telephone_number": "214-692-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "DWAIN",
        "credential": "M.D. .",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "D3227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129267407",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129267408",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129267409",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aileen Fullchange, LP
• Andrea Nicole Fuller, PA-C
• Dale Eugene Fuller, MD
• Dana A Fuller, MD
• Deborah A Fuller, M.D.
• Elise Fuller, COTA
• Elise J Fuller, MA, LPC
• Grant Fuller, OTA
• Jeffrey Fuller
• Julie Marie Fuller, MD

• Ophthalmology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.