Provider Demographics
NPI:1548357338
Name:FOREMAN, LEON JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:
Last Name:FOREMAN
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S GESSNER RD
Mailing Address - Street 2:STE 165 B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5100
Mailing Address - Country:US
Mailing Address - Phone:713-732-0706
Mailing Address - Fax:
Practice Address - Street 1:2401 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1513
Practice Address - Country:US
Practice Address - Phone:806-358-7633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215211223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice