Fuller Clinic,LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FULLER CLINIC,LLC

Practice address

909 W FM 495
Ste., 1
San Juan, TX 78589-3501

Phone

(956) 283-7400

Fax

(956) 283-7490

NPI assigned

Sep 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Lyn Reid, D.C.

Title

Chiropractor

Phone

(956) 283-7400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1689869299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W FM 495",
            "address_2": "STE., 1",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893501",
            "telephone_number": "956-283-7400",
            "fax_number": "956-283-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W FM 495",
            "address_2": "STE., 1",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893501",
            "telephone_number": "956-283-7400",
            "fax_number": "956-283-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER CLINIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "956-283-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.