=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396686499
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETHANY ANN LYDIA FISCHER RD/LD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2026
-----------------------------------------------------
Last Update Date | 04/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 523 LAUMAN AVE APT LS
-----------------------------------------------------
City | FORT SILL
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73503-1260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 636-775-3590
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3724 JEFFERSON ST
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78731-6225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 2898
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------