Provider Demographics
NPI:1811017106
Name:FISHER, ROBERT H (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:H
Last Name:FISHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 NE JOHNSON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4138
Mailing Address - Country:US
Mailing Address - Phone:817-447-2323
Mailing Address - Fax:817-447-3311
Practice Address - Street 1:113 NE JOHNSON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4138
Practice Address - Country:US
Practice Address - Phone:817-447-2323
Practice Address - Fax:817-447-3311
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1161628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist