Provider Demographics
NPI:1982371241
Name:FOSTER, MEAGAN SHANTAE (HAIR LOSS SPECISLIST)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:SHANTAE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:HAIR LOSS SPECISLIST
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:SHANTAE
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HAIR LOSS SPECIALIST
Mailing Address - Street 1:6033 GARTH RD APT 5305
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-9820
Mailing Address - Country:US
Mailing Address - Phone:346-216-2525
Mailing Address - Fax:
Practice Address - Street 1:6033 GARTH RD APT 5305
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9820
Practice Address - Country:US
Practice Address - Phone:346-216-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist