Provider Information for 1063990794
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MONIQUE COUMPY-FOSTER
Sex: Female
NPI: 1063990794
Last Updated: 2021-04-26
Certification Date: 2021-04-26
Certification Date: 2021-04-26
Details
| Name | Value | ||||||||||||
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| NPI | 1063990794 | ||||||||||||
| Enumeration Date | 2018-08-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1045 WESTERN HILLS DR FERRIS, TX 75125-1411 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 1545 W MOCKINGBIRD LN DALLAS, TX 75235-5014 United States Phone: 214-821-9554 | Fax: | ||||||||||||
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