Jessica Fuller

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

114 Indian Warrior TRL
Lake Jackson, TX 77566-3230

Phone

(979) 480-6682

NPI assigned

Mar 4, 2025

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Texas Medical School at San Antonio, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Valor Interventional Pain, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Granbury, TX
  • NPI 1073094967
  Medicare reassignment NPD
• Valor Interventional Pain, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Fort Worth, TX
  • NPI 1104440411
  NPD

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1497553663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 INDIAN WARRIOR TRL",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775663230",
            "telephone_number": "979-480-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 INDIAN WARRIOR TRL",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775663230",
            "telephone_number": "979-480-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dedra Deann Frazier, PH.D
• Craig K Freedman, M.D.
• Kim Freeman, MA DMD MS
• Melinda Friudenberg, FNP
• Richard C Fugler, DDS , MD
• Functional Healing, PLLC
• Matthew Flordelis Furman, LPC
• Kathryn Nicole Gadbois
• Michele Leigh Gambrel, PA-C
• Amanda Nicole Garcia, NP

• Physician Assistant in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.