Provider Demographics
NPI:1255080461
Name:FOSTER, SANDRA MARIE
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:MARIE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:MARIE
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2801 PINNACLE DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2615
Mailing Address - Country:US
Mailing Address - Phone:318-332-3027
Mailing Address - Fax:214-592-8764
Practice Address - Street 1:2801 PINNACLE DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2615
Practice Address - Country:US
Practice Address - Phone:318-332-3027
Practice Address - Fax:214-592-8764
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000000OtherHCBS