MEDICARE: MICHELLE ANN FOSTER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	25MP00813600	NJ
2	363A00000X	Physician Assistant	PA05929	TX
3	363A00000X	Physician Assistant	56902	CA

General Provider Information

NPI Number	:	1275861940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE ANN FOSTER PA-C

Provider Business Mailing Address
First Line	:	2410 E RIVERSIDE DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-3083
Country	:	US
Telephone Number	:	512-448-3778
Fax Number	:

Provider Business Practice Location Address
First Line	:	2410 E RIVERSIDE DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-3083
Country	:	US
Telephone Number	:	512-448-3778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2009
Last Update Date	:	05/18/2026

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Directions to “ MICHELLE ANN FOSTER PA-C” Practice Location

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