Provider Demographics
NPI:1114173903
Name:FISCHER, PHYLLIS L
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:L
Last Name:FISCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26222 RANCH RD 12
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4903
Mailing Address - Country:US
Mailing Address - Phone:512-858-0300
Mailing Address - Fax:512-858-2714
Practice Address - Street 1:1006 JUNCTION HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4934
Practice Address - Country:US
Practice Address - Phone:830-895-1020
Practice Address - Fax:830-792-3053
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50265237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist