Basic Information
Provider Information
NPI: 1326005232
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOSTER
FirstName: PRESTON
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8109 FREDERICKSBURG RD
Address2: PHYSICIAN PRACTICE SERVICES
City: SAN ANTONIO
State: TX
PostalCode: 782293311
CountryCode: US
TelephoneNumber: 2105758514
FaxNumber: 2105758004
Practice Location
Address1: 8201 EWING HALSELL DR
Address2: 2ND FLOOR
City: SAN ANTONIO
State: TX
PostalCode: 782293707
CountryCode: US
TelephoneNumber: 2105758514
FaxNumber: 2105758004
Other Information
ProviderEnumerationDate: 04/26/2006
LastUpdateDate: 05/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
204F00000XF9437TXY Allopathic & Osteopathic PhysiciansTransplant Surgery 
2086S0102XF9437TXN Allopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
208600000XF9437TXN Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
P0073671301TXRAILROADOTHER
14354140305TX MEDICAID
8BX12501TXBCBSOTHER
14354140401TXCSNOTHER


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