MEDICARE: DR. DAVID JULIAN FISHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	BP10049739	TX

General Provider Information

NPI Number	:	1619387834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JULIAN FISHER

Provider Business Mailing Address
First Line	:	2750 HOLLY HALL ST
Second Line	:	904
City	:	HOUSTON
State	:	TX
Zip	:	77054-4109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 HOLLY HALL ST
Second Line	:	904
City	:	HOUSTON
State	:	TX
Zip	:	77054-4109
Country	:	US
Telephone Number	:	909-915-4364
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	08/23/2016

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