Amber Rae Fuller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2126973 Issued in TX

Practice address

3501 S Loop 289
Lubbock, TX 79423-1139

Phone

(806) 796-1774

NPI assigned

Jun 7, 2016

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

Other names 1

• Miss Amber Rae Crawford Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1780033100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 EVANSTON AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246469",
            "telephone_number": "214-235-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231139",
            "telephone_number": "806-796-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "AMBER",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2126973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "CRAWFORD",
            "middle_name": "RAE",
            "prefix": "MISS",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandie Fulbright
• Connie Fulbright
• Victor Ray Fulford, NA
• Full Smile Dental Lakeridge, PLLC
• Addison Fuller
• Anthony Raymond Fuller, CRNA
• Christopher G. Fuller, M.D.
• Courtney Carole Fuller, BSN, RN
• Seunghee Oh Fuller, MD
• Jordan Fultz, PT

• Physical Therapy Assistant in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2017; 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.