Provider Demographics
NPI:1548362163
Name:FISHER, EARL THOMAS (PA-C)
Entity type:Individual
Prefix:MR
First Name:EARL
Middle Name:THOMAS
Last Name:FISHER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 WARING WELFARE RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-7926
Mailing Address - Country:US
Mailing Address - Phone:830-537-5165
Mailing Address - Fax:
Practice Address - Street 1:247 WARING WELFARE RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-7926
Practice Address - Country:US
Practice Address - Phone:830-537-5165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPAO1395363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical