Dana A Fuller, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

E8486 Issued in TX

Practice address

12700 Park Central Dr
Ste 430
Dallas, TX 75251-1527

Phone

(972) 239-8902

Fax

(972) 661-2551

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dfuller237649@direct.sw.org

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.

• Clinical Care in Radiology

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1578331393
  NPD (past)
• Diagnostic Health Centers of Texas, Limited Partnership

  • Physiological Laboratory
  • Beaumont, TX
  • NPI 1770531113
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1881697688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 PARK CENTRAL DR",
            "address_2": "STE 430",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511527",
            "telephone_number": "972-239-8902",
            "fax_number": "972-661-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 PARK CENTRAL DR",
            "address_2": "STE 430",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511527",
            "telephone_number": "972-239-8902",
            "fax_number": "972-661-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "DANA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "E8486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138887814",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Full Circle Counseling and Family Services, PLLC
• Full Life Outreach Medical Center LLC
• Aileen Fullchange, LP
• Andrea Nicole Fuller, PA-C
• Dale Eugene Fuller, MD
• Deborah A Fuller, M.D.
• Dwain Fuller, M.D. .
• Elise Fuller, COTA
• Elise J Fuller, MA, LPC
• Grant Fuller, OTA

• Diagnostic Radiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.