MEDICARE: MAURILIA V. FOSTER N.P.

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	363LA2200X	Adult Health Nurse Practitioner	652014	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609800648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURILIA V. FOSTER N.P.

Provider Business Mailing Address
First Line	:	1302 LANE ST STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75061-2201
Country	:	US
Telephone Number	:	469-800-1000
Fax Number	:	469-800-1010

Provider Business Practice Location Address
First Line	:	1307 8TH AVE STE 305
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4140
Country	:	US
Telephone Number	:	817-912-8000
Fax Number	:

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	10/02/2023

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