Provider Demographics
NPI:1144790254
Name:FOSTER, PAIGE M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:M
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4603
Mailing Address - Country:US
Mailing Address - Phone:325-793-3400
Mailing Address - Fax:
Practice Address - Street 1:4601 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4603
Practice Address - Country:US
Practice Address - Phone:325-793-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1307913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty