Active NPI
Mary Fisher
- Speech-Language Pathologist
- Conroe, TX
National Provider Identifier
1639373343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 13973
- Practice address
- 3421 W Davis St Ste 210
Conroe, TX 77304-1846 - Phone
- (979) 822-6467
- NPI assigned
- Jun 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 13973 | TX | Primary |
Addresses
Primary practice location
3421 W Davis St Ste 210
Conroe, TX 77304-1846
Mailing address
PO Box 4588
Bryan, TX 77805-4588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13973 | Other | TX | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13973 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639373343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4588",
"city": "BRYAN",
"state": "TX",
"postal_code": "778054588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3421 W DAVIS ST STE 210",
"city": "CONROE",
"state": "TX",
"postal_code": "773041846",
"telephone_number": "979-822-6467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "13973",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "13973",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.