Provider Demographics
NPI:1346336682
Name:FISHER, CLAY JEFFREY (MD)
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:JEFFREY
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9305 PINECROFT DRIVE
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3222
Mailing Address - Country:US
Mailing Address - Phone:281-943-2710
Mailing Address - Fax:281-943-2713
Practice Address - Street 1:9305 PINECROFT DRIVE
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3222
Practice Address - Country:US
Practice Address - Phone:281-943-2710
Practice Address - Fax:281-943-2713
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6106207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106015401Medicaid
TXF94294Medicare UPIN
GA200017004Medicare PIN
TX106015401Medicaid