| Doctor Name: | MARY ELIZABETH FULLER |
| NPI Number: | 1295052009 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 1194377 |
| Business Practice Address: | 4208 Retama Cir Victoria, TX - 779012765 |
| Business Phone Number: | 3615820602 |
| Business Fax Number: | 3615820509 |
| Mailing Address: | 2002 S Mason Rd Apt 1015, KATY |
| State: | TX |
| Postal Code: | 774507645 |
| Phone Number: | 3617821907 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2010 |
| NPI Last Update Date: | 08/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1194377 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |