Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT189375 | PA |
N | 208600000X | Surgeon | MT189375 | PA |
N | 208200000X | Surgeon | P6387 | TX |
N | 208600000X | Surgeon | P6387 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | P6387 | TX |
NPI | 1265634935 |
---|---|
Provider Name | Christine Fisher |
First Address | Austin, TX 78705-3548 |
Second Address | Austin, TX 78705-3548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 13/01/2021 |