NPI age
19 years
Enumerated 2006-08-30
● Active
Type 1 · Individual
Philip S Fuller, MD
Fuller is 1 of 18 pediatrics providers in Southlake and 1 of 7055 in Texas.
Primary specialty
Pediatrics
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-11-18
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 7055 active pediatrics providers in Texas.
NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
8% of peers hold multiple states
Subspecialties
1
In the 23% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
2727 E Southlake Blvd
Southlake, TX 760926613
Mailing address
Po Box 99213
Fort Worth, TX 761990213
Specialties
-
Pediatrics PrimaryA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment...
-
Emergency MedicinePediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.
Practice context
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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