Healthcare Provider Details

I. General information

NPI: 1588258743
Provider Name (Legal Business Name): AMY LYNN FISCHER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 HUTCHINS AVE STE A
BALLINGER TX
76821-4453
US

IV. Provider business mailing address

2001 HUTCHINS AVE STE A
BALLINGER TX
76821-4453
US

V. Phone/Fax

Practice location:
  • Phone: 325-365-3505
  • Fax:
Mailing address:
  • Phone: 325-365-3505
  • Fax: 325-365-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33774
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: