Provider Demographics
NPI:1679658207
Name:FOREMAN, YVONNE L (OTR)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:L
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 E PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8090
Mailing Address - Country:US
Mailing Address - Phone:956-507-4120
Mailing Address - Fax:888-506-6137
Practice Address - Street 1:2202 S 77 SUNSHINE STRIP STE C
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8332
Practice Address - Country:US
Practice Address - Phone:956-507-4120
Practice Address - Fax:888-506-6137
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111339225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1779399-01Medicaid
TX136482100OtherVALLEY HEALTHPLAN
TX8T6043OtherBLUE CROSS BLUE SHIELD