Provider Demographics
NPI:1396935490
Name:FULTON, ANITA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:MARIE
Last Name:FULTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANITA
Other - Middle Name:MARIE
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:21334 KUYKENDAHL
Mailing Address - Street 2:#A
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:281-528-7676
Mailing Address - Fax:281-528-8859
Practice Address - Street 1:21334 KUYKENDAHL
Practice Address - Street 2:#A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379
Practice Address - Country:US
Practice Address - Phone:281-528-7676
Practice Address - Fax:281-528-8859
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8658207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH65742Medicare UPIN