Individual
MR. RANDALL DWIGHT FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPA-C, ATC, LAT
Contact information
Practice address
561 N GRAHAM ST, STEPHENVILLE, TX 76401-3548
(254) 965-2663
(254) 968-7979
Mailing address
122 BYRON ST, STEPHENVILLE, TX 76401-4602
(254) 592-7329
(254) 968-7979
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1504
ATHLETIC TRAINER
TX
Enumeration date
07/03/2006
Last updated
01/16/2009
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