Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | E8468 | TX |
NPI | 1013949973 |
---|---|
Provider Name | Dr. John David Fisher |
First Address | Round Rock, TX 78664-5615 |
Second Address | Austin, TX 78741-6411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/07/2007 |