Provider Demographics
NPI:1295220481
Name:MEN'S HEALTH INSTITUTE, LLC
Entity Type:Organization
Organization Name:MEN'S HEALTH INSTITUTE, LLC
Other - Org Name:MEN'S HEALTH INSTITUTE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHEER
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:512-515-0065
Mailing Address - Street 1:6616 MILWAUKEE AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0627
Mailing Address - Country:US
Mailing Address - Phone:512-515-0065
Mailing Address - Fax:
Practice Address - Street 1:6616 MILWAUKEE AVE STE 400
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0627
Practice Address - Country:US
Practice Address - Phone:512-515-0065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty