Provider Demographics
NPI:1093859951
Name:FOSTER, JENNIFER KAY (PA-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:KAY
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 W CENTRAL TEXAS EXPY STE 210
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-7469
Mailing Address - Country:US
Mailing Address - Phone:254-618-4933
Mailing Address - Fax:254-618-1191
Practice Address - Street 1:1200 CARL RAMERT DR STE D
Practice Address - Street 2:
Practice Address - City:YOAKUM
Practice Address - State:TX
Practice Address - Zip Code:77995-4868
Practice Address - Country:US
Practice Address - Phone:361-293-7061
Practice Address - Fax:361-293-7892
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2021-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05142363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L10667Medicare PIN