Provider Demographics
NPI:1942246376
Name:FOOS, JAMES ALBERT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALBERT
Last Name:FOOS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MAPLEWOOD DR
Mailing Address - Street 2:#26
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4743
Mailing Address - Country:US
Mailing Address - Phone:361-676-8627
Mailing Address - Fax:
Practice Address - Street 1:101 MAPLEWOOD DR
Practice Address - Street 2:#26
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4743
Practice Address - Country:US
Practice Address - Phone:361-676-8627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23442103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164199502Medicaid
TX611447Medicare ID - Type Unspecified