Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | H5442 | TX |
NPI | 1043233679 |
---|---|
Provider Name | Dr. Thomas D Fisher |
First Address | Dallas, TX 75391-1230 |
Second Address | San Antonio, TX 78235-5155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 28/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136977902 | (05) | TX |
136977911 | (05) | TX |
4490743 | AETNA PPO (01) | TX |
830004813 | RAILROAD MEDICARE (01) | TX |
83Z204 | BLUECROSS/BLUESHIELD TX. (01) | TX |
921505 | AETNA HMO (01) | TX |
E41372 | (02) | TX |
P01547662 | RAILROAD MEDICARE (01) | TX |