Healthcare Provider Details

I. General information

NPI: 1588927719
Provider Name (Legal Business Name): MICHAEL LAWRENCE FOSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 E GEORGE BUSH HWY., STE 407
RICHARDSON TX
75082
US

IV. Provider business mailing address

2821 E GEORGE BUSH HWY., STE 407
RICHARDSON TX
75082
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 TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberQ4107
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: