Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G5842 | TX |
N | 208600000X | Surgeon | G5842 | TX |
Y | 2086S0129X | Vascular Surgeon | G5842 | TX |
NPI | 1013962349 |
---|---|
Provider Name | Travis Arno Foster |
First Address | North Richland Hills, TX 76180-8359 |
Second Address | North Richland Hills, TX 76180-8359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 11/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133090411 | (05) | TX |
C70705 | (02) | TX |