Individual provider Active NPI

Clifford Leon Foster III

  • Physical Therapy Assistant
  • Huntsville, TX
National Provider Identifier
1316802960
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2183303 Issued in TX
Practice address
127 Medical Park LN
Huntsville, TX 77340-4972
Phone
(936) 294-0283
Fax
(936) 294-9878
NPI assigned
Dec 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2183303 TX Primary

Addresses

Primary practice location

127 Medical Park LN
Huntsville, TX 77340-4972

Mailing address

127 Medical Park LN
Huntsville, TX 77340-4972
Phone (936) 294-0283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2183303TXMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wilco Theranet, LLC CurrentSince Dec 21, 2025 Accepting new patients
Physical Therapy Associates PastSince Dec 21, 2025 Accepting new patients

Locations

127 Medical Park Ln
Huntsville, TX 77340
Phone (936) 294-0283

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1316802960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MEDICAL PARK LN",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404972",
            "telephone_number": "936-294-0283",
            "fax_number": "936-294-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MEDICAL PARK LN",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404972",
            "telephone_number": "936-294-0283",
            "fax_number": "936-294-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "CLIFFORD",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2183303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.