Provider Demographics
NPI:1134407257
Name:FISCHER, MARSHALL DEAN (CCP)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:DEAN
Last Name:FISCHER
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 N HALL ST STE 510
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1320
Mailing Address - Country:US
Mailing Address - Phone:214-824-2510
Mailing Address - Fax:214-826-0130
Practice Address - Street 1:621 N HALL ST STE 510
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1320
Practice Address - Country:US
Practice Address - Phone:214-824-2510
Practice Address - Fax:214-826-0130
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTF1135242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist