Healthcare Provider Details

I. General information

NPI: 1518046580
Provider Name (Legal Business Name): FORSTER HEALTHCARE ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12414 ALDERBROOK DR STE 250
AUSTIN TX
78758-2596
US

IV. Provider business mailing address

12414 ALDERBROOK DR STE 250
AUSTIN TX
78758-2596
US

V. Phone/Fax

Practice location:
  • Phone: 512-834-2355
  • Fax: 512-834-0477
Mailing address:
  • Phone: 512-834-2355
  • Fax: 512-834-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5724
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1098549
License Number StateTX

VIII. Authorized Official

Name: DR. SIMON J FORSTER
Title or Position: PRESIDENT
Credential: DC
Phone: 512-834-2355