Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | M5166 | TX |
N | 207KA0200X | Allergist | M5166 | TX |
N | 2080P0201X | Pediatric Allergist | M5166 | TX |
NPI | 1801958236 |
---|---|
Provider Name | Dr. Samuel Burk Foster |
First Address | Denton, TX 76201-4314 |
Second Address | Denton, TX 76201-4314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/05/2017 |