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NPI Code Detail

MEDICARE: JUSTIN FOSS RN

MEDICARE: JUSTIN FOSS RN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1227548TX

General Provider Information

NPI Number : 1982145538
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN FOSS RN
Provider Business Mailing Address
First Line : 1430 COLLIER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2911
Country : US
Telephone Number : 512-445-7787
Fax Number : 512-440-4059
Provider Business Practice Location Address
First Line : 403 E 15TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78701-1437
Country : US
Telephone Number : 512-445-7783
Fax Number : 512-703-1390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2017
Last Update Date : 03/04/2026

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