Provider Demographics
NPI:1760640932
Name:BOBBY L. FISHER CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:BOBBY L. FISHER CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-957-7173
Mailing Address - Street 1:5383 SOUTHERN BLVD APT 435
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-7300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6021 MORRISS RD STE 104
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3762
Practice Address - Country:US
Practice Address - Phone:214-957-7173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty