Lydia Suzanne Fulton, PA-C

NPI #1407180763 in Oak Point, Texas

Provider Information

NPI Number: 1407180763
Entity Type: Individual
Name: Lydia Suzanne Fulton, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 18, 2009
Last Updated: Apr 17, 2015

Practice Location

Address: 508 HIGHMOOR CT
City: Oak Point
State: Texas
ZIP Code: 75068-6136
Phone: (618) 335-0992

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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