Fulsom, Donald Ray

Fulsom, Donald Ray is an sole proprietor health care provider with primary practice located at 306 E Houston St , Tyler TX 75702-8218. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry. Allopathic & Osteopathic Physicians / Addiction Psychiatry is his primary health care specialty. Fulsom, Donald Ray can be contacted via phone (903) 593-6550.

Contact Information

Primary practice address
306 E Houston St Tyler TX 75702-8218
Phone: (903) 593-6550
Fax: (903) 593-6554
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X L6047 Texas
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X L6047 Texas

Profile Details

NPI number 1679568794
LBN Legal business name Fulsom, Donald Ray
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2005
Last updated May 14th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679568794 NPPES
Texas MEDICAID 158042501

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