Provider Demographics
NPI:1013962349
Name:FOSTER, TRAVIS ARNO (MD)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:ARNO
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4375 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8359
Mailing Address - Country:US
Mailing Address - Phone:817-284-4500
Mailing Address - Fax:817-284-4505
Practice Address - Street 1:4375 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 501
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8359
Practice Address - Country:US
Practice Address - Phone:817-284-4500
Practice Address - Fax:817-284-4505
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5842208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133090411Medicaid
TXC70705Medicare UPIN
TX133090411Medicaid
TXP00927069Medicare PIN