Theresa Coronado Foreman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27377 Issued in TX

Practice address

1615 Barak LN
Bryan, TX 77802-3315

Phone

(979) 846-2500

Fax

(979) 595-1730

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1497039846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 CLOVER LN",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778089477",
            "telephone_number": "210-833-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 BARAK LN",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023315",
            "telephone_number": "979-846-2500",
            "fax_number": "979-595-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "THERESA",
        "middle_name": "CORONADO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Julius Florian, M.D.
• Mark Floyd, MD
• Shadell M Fluker
• McKinsey Ford, PHARM.D.
• Aaron Erwin Foreman, P.T.,C.P.O.
• Bruce Lee Forsyth, PT
• Jason Fort, LPC
• Cheryl Denice Foster, RN, FNP
• Essie Foster
• Suzan K Foster, PT

• General Practice Dentistry in Bryan, TX
• Providers in Bryan, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.