Provider Demographics
NPI:1336748797
Name:FOREMAN, ZACHARY JAMES (DC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JAMES
Last Name:FOREMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 E CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4216
Mailing Address - Country:US
Mailing Address - Phone:512-484-4685
Mailing Address - Fax:
Practice Address - Street 1:7900 FM 1826 STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-1410
Practice Address - Country:US
Practice Address - Phone:512-484-4685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor