MEDICARE: DR. KENT H FOSTER PH.D.

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	103G00000X	Clinical Neuropsychologist	23772	TX
2	103T00000X	Psychologist	23772	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932278116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENT H FOSTER PH.D.

Provider Business Mailing Address
First Line	:	711 W 38TH ST
Second Line	:	STE D3
City	:	AUSTIN
State	:	TX
Zip	:	78705-1131
Country	:	US
Telephone Number	:	512-797-7025
Fax Number	:	512-292-1144

Provider Business Practice Location Address
First Line	:	711 W 38TH ST
Second Line	:	STE D3
City	:	AUSTIN
State	:	TX
Zip	:	78705-1131
Country	:	US
Telephone Number	:	512-797-7025
Fax Number	:	512-292-1144

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	11/29/2017

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