Provider Demographics
NPI:1699961227
Name:FOSS, DANIEL RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RICHARD
Last Name:FOSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 NW MILITARY HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-2524
Mailing Address - Country:US
Mailing Address - Phone:210-685-1994
Mailing Address - Fax:
Practice Address - Street 1:2318 NW MILITARY HWY STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-2524
Practice Address - Country:US
Practice Address - Phone:210-685-1994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2020-05-11
Deactivation Date:2011-01-11
Deactivation Code:
Reactivation Date:2011-03-03
Provider Licenses
StateLicense IDTaxonomies
OR3631111N00000X
TX10880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor