Provider Demographics
NPI:1700221900
Name:S J FISHER & ASSOCIATES FOOT & ANKLE SPECIALIST PA
Entity Type:Organization
Organization Name:S J FISHER & ASSOCIATES FOOT & ANKLE SPECIALIST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYBIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-313-6300
Mailing Address - Street 1:5151 KATY FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2261
Mailing Address - Country:US
Mailing Address - Phone:832-673-0500
Mailing Address - Fax:832-673-0060
Practice Address - Street 1:15200 SOUTHWEST FWY STE 310
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3864
Practice Address - Country:US
Practice Address - Phone:281-313-6300
Practice Address - Fax:832-673-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1609213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174664602Medicaid
313665Medicare PIN