Provider Demographics
NPI:1639511553
Name:FISCHER, STEPHEN LEE (L P C)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:LEE
Last Name:FISCHER
Suffix:
Gender:M
Credentials:L P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6372 SEA ISLE
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77554-9660
Mailing Address - Country:US
Mailing Address - Phone:409-632-6968
Mailing Address - Fax:
Practice Address - Street 1:6372 SEA ISLE
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77554-9660
Practice Address - Country:US
Practice Address - Phone:409-632-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7657101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health