Individual
MIRELLE' JEANNE FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
551 HILL COUNTRY DR, KERRVILLE, TX 78028-6085
(830) 258-7824
(830) 896-9228
Mailing address
PO BOX 290142, KERRVILLE, TX 78029-0142
(830) 258-7824
(830) 896-9228
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
L3966
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152699801
—
TX
01
—
8AJ225
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/20/2007
Last updated
04/23/2008
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