Provider Demographics
NPI:1043723190
Name:FOSTER, WARNITA
Entity type:Individual
Prefix:
First Name:WARNITA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 CRICKLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6386
Mailing Address - Country:US
Mailing Address - Phone:254-432-1951
Mailing Address - Fax:254-432-1951
Practice Address - Street 1:3302 CRICKLEWOOD DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6386
Practice Address - Country:US
Practice Address - Phone:254-432-1951
Practice Address - Fax:254-432-1951
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13123521744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management