Provider Demographics
NPI:1508320995
Name:FISCHER, MONIQUE ALLYSE (PA)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ALLYSE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:112 HERFF RD
Mailing Address - Street 2:STE 110
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2751
Mailing Address - Country:US
Mailing Address - Phone:830-331-8585
Mailing Address - Fax:830-331-8586
Practice Address - Street 1:723 HILL COUNTRY DR STE C
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6043
Practice Address - Country:US
Practice Address - Phone:830-792-5800
Practice Address - Fax:830-896-2625
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA12600363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical