MEDICARE: MR. GARY LAYNE FOSTER RPH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18349	TX

General Provider Information

NPI Number	:	1477747475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY LAYNE FOSTER RPH.

Provider Business Mailing Address
First Line	:	10605 ROY BUTLER DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78717-3906
Country	:	US
Telephone Number	:	512-255-1751
Fax Number	:

Provider Business Practice Location Address
First Line	:	10605 ROY BUTLER DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78717-3906
Country	:	US
Telephone Number	:	512-255-1751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2007
Last Update Date	:	09/02/2007

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