Provider Demographics
NPI:1801803143
Name:FISCHER, RICHARD EMIL (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EMIL
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 FREDERICKSBURG RD
Mailing Address - Street 2:PHYSICIAN PRACTICE SERVICES
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3259
Mailing Address - Country:US
Mailing Address - Phone:210-653-9307
Mailing Address - Fax:210-653-7014
Practice Address - Street 1:12709 TOEPPERWEIN
Practice Address - Street 2:302
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3259
Practice Address - Country:US
Practice Address - Phone:210-653-9307
Practice Address - Fax:210-653-7014
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8698208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01176218OtherMEDICARE RAILROAD
TX033645507Medicaid
TX8DE698OtherBCBS
P01176218OtherMEDICARE RAILROAD