MEDICARE: DR CHARLES A FOSTER

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	152W00000X	Optometrist	2491T	TX

General Provider Information

NPI Number	:	1851692040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR CHARLES A FOSTER

Provider Business Mailing Address
First Line	:	1233 E PLEASANT RUN RD
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4200
Country	:	US
Telephone Number	:	972-223-2020
Fax Number	:	972-228-1860

Provider Business Practice Location Address
First Line	:	1233 E PLEASANT RUN RD
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4200
Country	:	US
Telephone Number	:	972-223-2020
Fax Number	:	972-228-1860

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHARLES ARNOLD FOSTER
Credential	:	O.D.
Telephone Number	:	972-223-2020

Provider Enumeration Date	:	11/04/2010
Last Update Date	:	11/04/2010

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Directions to “DR CHARLES A FOSTER ” Practice Location

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