Provider Demographics
NPI:1750312377
Name:FOSTER, DAVID P (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14202 S PADRE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6030
Mailing Address - Country:US
Mailing Address - Phone:361-949-6290
Mailing Address - Fax:361-949-4950
Practice Address - Street 1:14202 S PADRE ISLAND DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6030
Practice Address - Country:US
Practice Address - Phone:361-949-6290
Practice Address - Fax:361-949-4950
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1034795-02Medicaid
TX86453FMedicare ID - Type Unspecified
TX1034795-02Medicaid