Provider Demographics
NPI:1417950189
Name:FISCHER, JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-1615
Mailing Address - Country:US
Mailing Address - Phone:512-868-8179
Mailing Address - Fax:512-733-0400
Practice Address - Street 1:10625 PARMER LN
Practice Address - Street 2:SUITE D400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717
Practice Address - Country:US
Practice Address - Phone:512-733-9400
Practice Address - Fax:512-733-0400
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI23054Medicare UPIN
CA020A90530Medicare ID - Type Unspecified