Individual
DR. RODERICK JOHN FISETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 TURNER DR, BRIDGE CITY, TX 77611-2612
(409) 221-1500
Mailing address
PO BOX 296, BRIDGE CITY, TX 77611-0296
(409) 221-1500
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D6746
TX
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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