Provider Demographics
NPI:1962577106
Name:FOSTER, DANIEL L (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2008 L DON DODSON DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-1844
Mailing Address - Country:US
Mailing Address - Phone:817-283-0967
Mailing Address - Fax:817-475-2538
Practice Address - Street 1:2008 L DON DODSON DR STE 110
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-1844
Practice Address - Country:US
Practice Address - Phone:817-283-0967
Practice Address - Fax:817-475-2538
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF6632207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84G532Medicare ID - Type Unspecified
TXB22773Medicare UPIN