MEDICARE: DR. BERNARD FISCHBACH M.D.

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	207RN0300X	Nephrology Physician	L6378	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	L6378	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1225016819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNARD FISCHBACH M.D.

Provider Business Mailing Address
First Line	:	1505 LBJ FWY STE 700
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-6065
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-579-6941

Provider Business Practice Location Address
First Line	:	1250 8TH AVE STE 135
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4156
Country	:	US
Telephone Number	:	214-358-2300
Fax Number	:	214-579-6993

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	11/14/2023

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