Provider Demographics
NPI:1336369206
Name:FOSTER, CARLOS (DC7285)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DC7285
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76103-3836
Mailing Address - Country:US
Mailing Address - Phone:817-413-8000
Mailing Address - Fax:817-413-8001
Practice Address - Street 1:4716 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-3836
Practice Address - Country:US
Practice Address - Phone:817-413-8000
Practice Address - Fax:817-413-8001
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC7285111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology