Individual provider Active NPI

Thomas Boone Fisher, MD

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1871833673
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
E6350 Issued in TX
Practice address
6931 Azalea LN
Dallas, TX 75230-3565
Phone
(214) 893-9083
NPI assigned
Feb 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X E6350 TX Primary

Addresses

Primary practice location

6931 Azalea LN
Dallas, TX 75230-3565

Mailing address

6931 Azalea LN
Dallas, TX 75230-3565
Phone (214) 893-9083

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E6350TXMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1871833673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6931 AZALEA LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752303565",
            "telephone_number": "214-893-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 AZALEA LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752303565",
            "telephone_number": "214-893-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "THOMAS",
        "middle_name": "BOONE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "E6350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.