Provider Demographics
NPI:1194716993
Name:FOSTER, GREGORY H (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:H
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 1:2821 GEORGE BUSH HWY STE 407
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4279
Mailing Address - Country:US
Mailing Address - Phone:972-680-0668
Mailing Address - Fax:972-680-2499
Practice Address - Street 1:2821 GEORGE BUSH HWY STE 407
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4279
Practice Address - Country:US
Practice Address - Phone:972-680-0668
Practice Address - Fax:972-680-2499
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6508207R00000X, 207RC0200X, 207RS0010X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103744202Medicaid
TX103744202Medicaid
TXC15672Medicare UPIN