Basic Information
| Provider Information | |||||||||
| NPI: | 1669454880 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOSS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9319 BEREAN WAY | ||||||||
| Address2: | |||||||||
| City: | GARDEN RIDGE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782662504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104732927 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3851 ROGER BROOKE DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109160808 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2005 | ||||||||
| LastUpdateDate: | 06/26/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 9300116 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.