Provider Demographics
NPI:1346508801
Name:CHARLES A FOSTER O.D.
Entity Type:Organization
Organization Name:CHARLES A FOSTER O.D.
Other - Org Name:CEDAR HILL EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:II
Authorized Official - Credentials:OD
Authorized Official - Phone:972-293-2020
Mailing Address - Street 1:818 N HIGHWAY 67
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2102
Mailing Address - Country:US
Mailing Address - Phone:972-293-2020
Mailing Address - Fax:
Practice Address - Street 1:818 N HIGHWAY 67
Practice Address - Street 2:SUITE 104
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2102
Practice Address - Country:US
Practice Address - Phone:972-293-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARLES A FOSTER II OD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2491T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty