Donald Ray Fulsom, M.D.

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

L6047 Issued in TX

Practice address

306 E Houston St
Tyler, TX 75702-8218

Phone

(903) 593-6550

Fax

(903) 593-6554

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

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.

• Psychology Associates of East Texas, LLC.

  • Mental Health Counselor
  • Tyler, TX
  • NPI 1588061923

  Single Specialty

  NPD (past)
• Tyler Psychology Group LLP

  • Mental Health Counselor
  • Tyler, TX
  • NPI 1285769216

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1679568794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E HOUSTON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028218",
            "telephone_number": "903-593-6550",
            "fax_number": "903-593-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E HOUSTON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028218",
            "telephone_number": "903-593-6550",
            "fax_number": "903-593-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULSOM",
        "first_name": "DONALD",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "L6047",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TX",
            "license": "L6047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158042501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nayeli Fuentes, MD
• Carley Rae Fugler
• Cletus Fuhrmann
• Daniel W Fuller, ATC. LAT.
• Tatum Vanmeter Fuller, RBT
• Functional Performance Analysts, L.P.
• Amber Furlow, NP
• Melisa Furnish
• Amy Furqueron, LPC
• Buddy D Furqueron, DDS

• Addiction Psychiatry Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Addiction Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.