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Dr. Timothy Richard Fullam, MD
Neurology Physician in Jbsa Ft Sam Houston, Texas
NPI 1952720104

Timothy Richard Fullam is a Neurology Physician based in Jbsa Ft Sam Houston, TX and is specialized in Neurology. Timothy Richard Fullam practices in Jbsa Ft Sam Houston, TX and has the professional credentials of MD. The NPI Number for Timothy Richard Fullam is 1952720104 and holds a License No. T1068 (Texas).

The current practice location address for Timothy Richard Fullam is 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX and can be reached out via phone at 210-916-2203 and via fax at 210-916-2203.

Location: 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX, 78234-4504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952720104
Provider Name
Timothy Richard Fullam
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX, 78234-4504
Phone Number
210-916-2203
Fax Number
210-916-2203
Provider Enumeration Date
04/15/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
19552780104 05 TX
institution
Provider Business Practice Location Address Details
Address
3551 Roger Brooke Dr
City
Jbsa Ft Sam Houston
State
Texas
Zip
78234-4504
Phone Number
210-916-2203
Fax Number
210-916-2203
person
Provider Business Mailing Address Details
Address
3551 Roger Brooke Dr
City
Jbsa Ft Sam Houston
State
Texas
Zip
78234-4504
Phone Number
210-916-2203
Fax Number
210-916-2203
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neuromuscular Medicine
Taxonomy
2084N0008X
License No.
T1068 (Texas)
Definition
A neurologist or child neurologist who specializes in the diagnosis and management of disorders of nerve, muscle or neuromuscular junction, including amyotrophic lateral sclerosis, peripheral neuropathies (e.g., diabetic and immune mediated neuropathies), various muscular dystrophies, congenital and acquired myopathies, inflammatory myopathies (e.g., polymyositis, inclusion body myositis) and neuromuscular transmission disorders (e.g., myasthenia gravis, Lambert-Eaton myasthenic syndrome).
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
28833 (Nebraska)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
T1068 (Texas)
Definition
Definition to come...
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