Provider Demographics
NPI:1730183567
Name:FOREMAN, MARK ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:FOREMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MC7977
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:
Practice Address - Street 1:8300 FLOYD CURL DR
Practice Address - Street 2:3RD FL -3C
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3931
Practice Address - Country:US
Practice Address - Phone:210-450-9300
Practice Address - Fax:210-450-6023
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20981207X00000X
TXJ6436207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103135303Medicaid
OR151212Medicaid
TX103135303Medicaid
TXTXB106831Medicare PIN
OR112144Medicare ID - Type Unspecified