Individual
DANE MICHAEL FISHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-0808
(210) 916-6654
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-0808
(210) 916-6654
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101287414
VA
Other
Enumeration date
03/25/2024
Last updated
09/12/2025
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