Provider Demographics
NPI:1073406419
Name:FISHER, MADISON RYAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:RYAN
Last Name:FISHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 CAMINO ANGELES
Mailing Address - Street 2:
Mailing Address - City:FISCHER
Mailing Address - State:TX
Mailing Address - Zip Code:78623-2183
Mailing Address - Country:US
Mailing Address - Phone:832-640-3360
Mailing Address - Fax:
Practice Address - Street 1:400 US-290 STE A 102
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620
Practice Address - Country:US
Practice Address - Phone:512-964-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1406767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist