Provider Demographics
NPI:1497077192
Name:FISHER, TERENCE JONES (LVN)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:JONES
Last Name:FISHER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19719 LAJUANA LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-6119
Mailing Address - Country:US
Mailing Address - Phone:281-528-0769
Mailing Address - Fax:281-528-0769
Practice Address - Street 1:19719 LAJUANA LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-6119
Practice Address - Country:US
Practice Address - Phone:281-528-0769
Practice Address - Fax:281-528-0769
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1013230754Medicaid
TX1629138144Medicaid