Provider Demographics
NPI:1528275617
Name:FOREMAN, NANCY L (MS CCC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 BISSONNET ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3121
Mailing Address - Country:US
Mailing Address - Phone:713-770-0803
Mailing Address - Fax:713-218-7593
Practice Address - Street 1:4545 BISSONNET ST
Practice Address - Street 2:SUITE 215
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3121
Practice Address - Country:US
Practice Address - Phone:713-770-0803
Practice Address - Fax:713-218-7593
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10147235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7088315OtherAETNA PROVIDER #
TX760629639OtherTAX ID
TX87880TOtherBCBS PROVIDER #