Provider Demographics
NPI:1467644906
Name:MARCUS FOOS, M.D., P.A.
Entity Type:Organization
Organization Name:MARCUS FOOS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FOOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-626-3844
Mailing Address - Street 1:PO BOX 1563
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6148
Mailing Address - Country:US
Mailing Address - Phone:940-626-3844
Mailing Address - Fax:940-626-3847
Practice Address - Street 1:609 MEDICAL CENTER DR
Practice Address - Street 2:SUITE #100
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3836
Practice Address - Country:US
Practice Address - Phone:940-626-3844
Practice Address - Fax:940-626-3847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081QCOtherBCBS
TXPENDINGMedicaid
TX00Y446Medicare PIN