Provider Demographics
NPI:1902035801
Name:FOADEY, TONGNY WILFRIED (MD)
Entity Type:Individual
Prefix:DR
First Name:TONGNY
Middle Name:WILFRIED
Last Name:FOADEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 WEBBERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2947
Mailing Address - Country:US
Mailing Address - Phone:512-978-9400
Mailing Address - Fax:512-901-9726
Practice Address - Street 1:2802 WEBBERVILLE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2947
Practice Address - Country:US
Practice Address - Phone:512-978-9400
Practice Address - Fax:512-901-9726
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10035420207Q00000X
TXP2115207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
267376YLCDMedicare PIN