Provider Demographics
NPI:1376716233
Name:CHARLIE D. FOSTER, D.C., P.A.
Entity Type:Organization
Organization Name:CHARLIE D. FOSTER, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:915-751-9791
Mailing Address - Street 1:9005 DYER ST STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-1452
Mailing Address - Country:US
Mailing Address - Phone:915-751-9791
Mailing Address - Fax:915-751-0993
Practice Address - Street 1:9005 DYER ST STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-1452
Practice Address - Country:US
Practice Address - Phone:915-751-9791
Practice Address - Fax:915-751-0993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF008112261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608456OtherBLUE CROSS BLUE SHIELD