Individual
SUSAN R. FOGLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 847556, DALLAS, TX 75284-7556
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT01331
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8U3090
BLUE SHIELD
TX
Enumeration date
04/06/2006
Last updated
07/11/2007
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