Healthcare Provider Details

I. General information

NPI: 1194716993
Provider Name (Legal Business Name): GREGORY H FOSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 GEORGE BUSH HWY STE 407
RICHARDSON TX
75082-4279
US

IV. Provider business mailing address

2821 GEORGE BUSH HWY STE 407
RICHARDSON TX
75082-4279
US

V. Phone/Fax

Practice location:
  • Phone: 972-680-0668
  • Fax: 972-680-2499
Mailing address:
  • Phone: 972-680-0668
  • Fax: 972-680-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG6508
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG6508
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberG6508
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG6508
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: