Provider Demographics
NPI:1265549737
Name:FISHER, ALAN T (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:T
Last Name:FISHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 S STAPLES ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4656
Mailing Address - Country:US
Mailing Address - Phone:361-992-9624
Mailing Address - Fax:361-993-3921
Practice Address - Street 1:5402 S STAPLES ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4656
Practice Address - Country:US
Practice Address - Phone:361-992-9624
Practice Address - Fax:361-993-3921
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX21129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical