Most Relevant Information
Provider Data
| NPI Number: | 1003585381 |
| Provider Name: | DYLAN TODD FULFORD PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/09/2021 |
| Last Updated: | 06/13/2023 |
Provider Practice Location
1620 8TH ST
WICHITA FALLS
TX
763013108
Practice Location Phone/Fax
| Phone: | 9407645400 |
| Fax: | 9407645454 |
Provider Mailing Location
PO BOX 9261
WICHITA FALLS
TX
763089261
Provider Mailing Phone/Fax
| Phone: | 9407647230 |
| Fax: | 9407647255 |