MEDICARE: LAUREN FISKE 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	2084P0800X	Psychiatry Physician	A147252	CA
2	2084P0800X	Psychiatry Physician	T0081	TX

General Provider Information

NPI Number	:	1528449436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN FISKE M.D.

Provider Business Mailing Address
First Line	:	1401 LAVACA ST # 916
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1634
Country	:	US
Telephone Number	:	512-253-2334
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 LAVACA ST # 916
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1634
Country	:	US
Telephone Number	:	512-253-2334
Fax Number	:

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

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	02/12/2025

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