Individual
RUSSELL G FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1305 AIRPORT FWY, SUITE 424, BEDFORD, TX 76021-6605
(817) 510-1060
(817) 510-9940
Mailing address
1305 AIRPORT FWY, SUITE 424, BEDFORD, TX 76021-6605
(817) 510-1060
(817) 510-9940
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G9453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138616115
—
TX
05
—
138616116
—
TX
05
—
138616117
—
TX
Enumeration date
08/15/2005
Last updated
10/01/2014
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