Provider Demographics
NPI:1700939618
Name:FOSTER, STEPHANIE LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:9622 WEBB CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-4940
Mailing Address - Country:US
Mailing Address - Phone:214-358-3601
Mailing Address - Fax:214-358-3639
Practice Address - Street 1:9622 WEBB CHAPEL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4940
Practice Address - Country:US
Practice Address - Phone:214-358-3601
Practice Address - Fax:214-358-3639
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2020-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX07704363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant