Basic Information
Provider Information
NPI: 1922458074
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOSTER
FirstName: CHRISTINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 204 E 1ST ST
Address2:  
City: ALICE
State: TX
PostalCode: 783324822
CountryCode: US
TelephoneNumber: 3613960370
FaxNumber: 3616642247
Practice Location
Address1: 301 S HILLSIDE DR
Address2: 5,6,15
City: BEEVILLE
State: TX
PostalCode: 781025307
CountryCode: US
TelephoneNumber: 3613620307
FaxNumber: 8557901889
Other Information
ProviderEnumerationDate: 06/20/2016
LastUpdateDate: 06/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP131205TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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