Lesa Monette Fuller, MS,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

101813 Issued in TX

Practice address

4930 Siros Isle Court
Spring, TX 77388

Phone

(281) 288-7406

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Lesa Perry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740401355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 SIROS ISLE COURT",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77388",
            "telephone_number": "281-288-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 SIROS ISLE COURT",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "77388",
            "telephone_number": "281-288-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LESA",
        "middle_name": "MONETTE",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101813",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000003483",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA-3964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESA",
            "last_name": "PERRY",
            "credential": "MS,CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Full Circle Therapy PLLC
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• Kenneth Michael Fuller Jr., FNP
• Kevin Antonio Fuller, M.A., LPC
• Valeria Fuller
• Anita Marie Fulton, MD
• Fun in Swimming Incorporated
• Jania Joy Fusilier
• Danielle Gabinete, SLP-ASSISTANT

• Speech-Language Pathologist in Spring, TX
• Providers in Spring, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.