MEDICARE: DR. TIMOTHY FISHMAN DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	006554	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	213E00000X	Podiatrist	692183	TX

General Provider Information

NPI Number	:	1083933618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY FISHMAN DPM

Provider Business Mailing Address
First Line	:	625 PARKVIEW DR STE 102
Second Line	:
City	:	TROPHY CLUB
State	:	TX
Zip	:	76262-4204
Country	:	US
Telephone Number	:	817-527-6537
Fax Number	:	469-620-7558

Provider Business Practice Location Address
First Line	:	625 PARKVIEW DR STE 102
Second Line	:
City	:	TROPHY CLUB
State	:	TX
Zip	:	76262-4204
Country	:	US
Telephone Number	:	917-667-4514
Fax Number	:	469-620-7558

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

Provider Enumeration Date	:	05/21/2010
Last Update Date	:	06/26/2025

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Directions to “ DR. TIMOTHY FISHMAN DPM” Practice Location

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