MEDICARE: CAMRYN MILLER FISH

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1679374169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMRYN MILLER FISH

Provider Business Mailing Address
First Line	:	4310 W STATE HIGHWAY 29
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-7009
Country	:	US
Telephone Number	:	512-924-0703
Fax Number	:

Provider Business Practice Location Address
First Line	:	4910 MUELLER BLVD STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78723-3079
Country	:	US
Telephone Number	:	512-628-1900
Fax Number	:

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

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/05/2026

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