Provider Demographics
NPI:1548316706
Name:FOREMAN, WESLEY D (MD)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:D
Last Name:FOREMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR STE 8235
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:512-503-1974
Mailing Address - Fax:
Practice Address - Street 1:930 S BELL BLVD STE 206
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3974
Practice Address - Country:US
Practice Address - Phone:512-503-1974
Practice Address - Fax:833-464-4169
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6895208VP0014X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209668304Medicaid
TX209668304Medicaid
TXTXB105593Medicare PIN