Provider Demographics
NPI:1245232461
Name:FISCHER, CONRAD ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:ALEXANDER
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:250 BLOSSOM ST
Mailing Address - Street 2:STE 230
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4204
Mailing Address - Country:US
Mailing Address - Phone:281-554-4769
Mailing Address - Fax:281-554-4817
Practice Address - Street 1:250 BLOSSOM ST
Practice Address - Street 2:STE 230
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4241
Practice Address - Country:US
Practice Address - Phone:281-554-4769
Practice Address - Fax:281-554-4817
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE7071207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122582303Medicaid
TXB95591Medicare UPIN
TX122582303Medicaid