MEDICARE: ADAM FISH DO

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	207L00000X	Anesthesiology Physician	T3771	TX
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	T3771	TX

General Provider Information

NPI Number	:	1689105678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM FISH DO

Provider Business Mailing Address
First Line	:	5522 LONE STAR PKWY STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6719
Country	:	US
Telephone Number	:	210-298-6630
Fax Number	:	210-298-6631

Provider Business Practice Location Address
First Line	:	5522 LONE STAR PKWY BLDG 2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6719
Country	:	US
Telephone Number	:	210-298-6630
Fax Number	:	210-298-6631

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

Provider Enumeration Date	:	03/22/2017
Last Update Date	:	03/04/2025

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Directions to “ ADAM FISH DO” Practice Location

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