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General NPI Number Information
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NPI Number | 1528363165
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Entity Type | Individual
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Provider Name | SHANNON FOSTER
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Gender | Female
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 1609 JUDSON RD
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City | LONGVIEW
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State | TX
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Zip | 75601-3663
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Country | US
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Telephone | 903-753-5329
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Fax | 903-753-6818
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Provider Business Mailing Address
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Address Line | 1609 JUDSON RD
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City | LONGVIEW
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State | TX
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Zip | 75601-3663
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Country | US
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Telephone | 903-753-5329
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Fax | 903-753-6818
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 80434
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License Number State | TX
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