Provider Demographics
NPI:1487854402
Name:FOSTER, SUZAN K (PT)
Entity Type:Individual
Prefix:
First Name:SUZAN
Middle Name:K
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:3700 CROSS PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-4137
Mailing Address - Country:US
Mailing Address - Phone:979-774-9958
Mailing Address - Fax:979-774-9978
Practice Address - Street 1:1121 BRIARCREST DR
Practice Address - Street 2:100
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2505
Practice Address - Country:US
Practice Address - Phone:979-774-5300
Practice Address - Fax:979-776-5173
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2013-06-19
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Provider Licenses
StateLicense IDTaxonomies
TX1059830208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L9680Medicare PIN