Provider Demographics
NPI:1497880306
Name:FISHER, BOBBY LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:LEE
Last Name:FISHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6021 MORRISS RD
Mailing Address - Street 2:#104
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3710
Mailing Address - Country:US
Mailing Address - Phone:972-355-1939
Mailing Address - Fax:972-355-4813
Practice Address - Street 1:6021 MORRISS RD
Practice Address - Street 2:#104
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3710
Practice Address - Country:US
Practice Address - Phone:972-355-1939
Practice Address - Fax:972-355-4813
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor