Provider Demographics
NPI:1518046580
Name:FORSTER HEALTHCARE ASSOCIATES PA
Entity Type:Organization
Organization Name:FORSTER HEALTHCARE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:J
Authorized Official - Last Name:FORSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-834-2355
Mailing Address - Street 1:12414 ALDERBROOK DR
Mailing Address - Street 2:STE 250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2596
Mailing Address - Country:US
Mailing Address - Phone:512-834-2355
Mailing Address - Fax:512-834-0477
Practice Address - Street 1:12414 ALDERBROOK DR
Practice Address - Street 2:STE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2596
Practice Address - Country:US
Practice Address - Phone:512-834-2355
Practice Address - Fax:512-834-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5724111N00000X
TX1098549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5724OtherLICENSE
TX5724OtherLICENSE
TX603720Medicare ID - Type Unspecified