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General NPI Number Information
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NPI Number | 1629387485
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Entity Type | Individual
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Provider Name | DAVID FISCU CNA
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Gender | Male
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 13715 STAGECOACH RD
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City | MAGNOLIA
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State | TX
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Zip | 77355-3859
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Country | US
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Telephone | 281-259-8979
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Fax | 832-934-0172
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Provider Business Mailing Address
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Address Line | 13715 STAGECOACH RD
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City | MAGNOLIA
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State | TX
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Zip | 77355-3859
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Country | US
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Telephone | 281-259-8979
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Fax | 832-934-0172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 128689
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License Number State | TX
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