Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | P4165 | TX |
NPI | 1013170059 |
---|---|
Provider Name | Dr. Dalton A Foster |
First Address | Dallas, TX 75284-0853 |
Second Address | Houston, TX 77042-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 22/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
311436501 | (05) | TX |
311436502 | (05) | TX |
8DL181 | BLUE CROSS BLUE SHIELD (01) | TX |
P01171067 | RAILROAD MEDICARE (01) | TX |