Provider Demographics
NPI:1871902916
Name:FISHER, DAMIEN RYINN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAMIEN
Middle Name:RYINN
Last Name:FISHER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 COBIA DR
Mailing Address - Street 2:APT 211
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1681
Mailing Address - Country:US
Mailing Address - Phone:850-445-4866
Mailing Address - Fax:
Practice Address - Street 1:12603 SOUTHWEST FWY
Practice Address - Street 2:SUITE 335
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3820
Practice Address - Country:US
Practice Address - Phone:281-269-6713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX463801835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist