Provider Demographics
NPI:1619387834
Name:FISHER, DAVID JULIAN
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JULIAN
Last Name:FISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 HOLLY HALL ST
Mailing Address - Street 2:904
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2750 HOLLY HALL ST
Practice Address - Street 2:904
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4109
Practice Address - Country:US
Practice Address - Phone:909-915-4364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10049739207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine