Provider Demographics
NPI:1902875958
Name:KOSTER, ERIN LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEA
Last Name:KOSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 AVON LANE
Mailing Address - Street 2:SUITE 180B
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1547
Mailing Address - Country:US
Mailing Address - Phone:972-704-1318
Mailing Address - Fax:972-987-5507
Practice Address - Street 1:4645 AVON LANE
Practice Address - Street 2:SUITE 180B
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1547
Practice Address - Country:US
Practice Address - Phone:972-704-1318
Practice Address - Fax:972-987-5507
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3562207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144451504Medicaid
TX8U2081OtherBCBS
TX8F1288Medicare ID - Type Unspecified
TX144451504Medicaid