Provider Demographics
NPI:1609932078
Name:FUGLER, RICHARD C (DDS , MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:FUGLER
Suffix:
Gender:M
Credentials:DDS , MD
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Mailing Address - Street 1:103 ABNER JACKSON PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566
Mailing Address - Country:US
Mailing Address - Phone:979-299-6878
Mailing Address - Fax:979-299-6166
Practice Address - Street 1:103 ABNER JACKSON PKWY
Practice Address - Street 2:STE A
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566
Practice Address - Country:US
Practice Address - Phone:979-299-6878
Practice Address - Fax:979-299-6166
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2023-10-25
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Provider Licenses
StateLicense IDTaxonomies
TXK6850204E00000X
TX168291223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery