Burcham Cooper Fuqua Jr., MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

F9456 Issued in TX

Practice address

3434 Saratoga Blvd
Corpus Christi, TX 78415-5822

Phone

(361) 985-9355

Fax

(361) 992-3458

NPI assigned

Nov 16, 2005

Last updated

Jul 14, 2016By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peggy Johnson DO PA

  • Primary Care Clinic/Center
  • Corpus Christi, TX
  • NPI 1497824767
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1396727392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 SARATOGA BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784155822",
            "telephone_number": "361-985-9355",
            "fax_number": "361-992-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 SARATOGA BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784155822",
            "telephone_number": "361-985-9355",
            "fax_number": "361-992-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "BURCHAM",
        "middle_name": "COOPER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F9456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122175602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "TXB149313",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122175606",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Fuentes III, D.O.
• Michael Gerard Fuentes, M.D.
• Randy Anthony Fuentes, M.D.
• Christal Dawn Fuller, OT
• Crystal Lee Fultz
• Brooklynn Faith Furnish, SLPA
• Future Focus Direct
• Fyzical Corpus Christi LLC (Fyzical Corpus Christi)
• Catherine Gabbert
• Teresa Gabiano, NP

• Internal Medicine Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.