Individual provider Active NPI

Kevin Edward Fisher, M.D., PH.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Houston, TX
National Provider Identifier
1386886687
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
Q0632 Issued in TX
Practice address
6621 Fannin St Ste Ab1195
Houston, TX 77030-2360
Phone
(832) 824-1866
NPI assigned
Apr 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Q0632 TX Primary

Addresses

Primary practice location

6621 Fannin St Ste Ab1195
Houston, TX 77030-2360

Mailing address

3579 Midvale Forest CT
Tucker, GA 30084-2350
Phone (770) 864-7317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140807000190 TX Practitioner - Pathology 0042437568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Missouri, Columbia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens HospitalGroup PAC ID 0244298446, 23 clinicians

Practice addresses (Care Compare)

6621 Fannin St
Houston, TX 77030-2358
Phone (832) 824-6422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
Q0632TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Childrens Hospital Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2014 Accepting new patients
Texas Childrens Hospital Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2014 Accepting new patients

Locations

18200 Katy Fwy
Houston, TX 77094
Phone (832) 227-1000

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6621 Fannin St
Ste AB1195
Houston, TX 77030
Phone (832) 824-1866

17600 Interstate 45 S
Ste WL270
The Woodlands, TX 77384
Phone (936) 267-5000

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1386886687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 MIDVALE FOREST CT",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300842350",
            "telephone_number": "770-864-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE AB1195",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302360",
            "telephone_number": "832-824-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "Q0632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.