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General NPI Number Information
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NPI Number | 1689070500
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Entity Type | Individual
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Provider Name | MATTIE FOSTER
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Gender | Female
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 5711 LANGHAM DAWN LN
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City | HOUSTON
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State | TX
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Zip | 77084-6924
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Country | US
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Telephone | 832-217-4339
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Fax |
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Provider Business Mailing Address
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Address Line | 5711 LANGHAM DAWN LN
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City | HOUSTON
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State | TX
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Zip | 77084-6924
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Country | US
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Telephone | 832-217-4339
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Fax |
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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 | 172A00000X
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Taxonomy Name | Driver
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License Number | 16770328
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License Number State | TX
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