Provider Demographics
NPI:1245322296
Name:FISCHER, LAURICE KAY (MD)
Entity type:Individual
Prefix:DR
First Name:LAURICE
Middle Name:KAY
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURICE
Other - Middle Name:KAY
Other - Last Name:HATRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:900 AIRPORT FWY
Mailing Address - Street 2:STE 132
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3250
Mailing Address - Country:US
Mailing Address - Phone:817-514-4005
Mailing Address - Fax:
Practice Address - Street 1:900 AIRPORT FWY
Practice Address - Street 2:STE 132
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3250
Practice Address - Country:US
Practice Address - Phone:817-514-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5628390200000X, 207ZP0102X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX448037YNGSMedicare PIN