MEDICARE: FOUNDATION HEALTHCARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	819885	OTHER	TX	MEDICARE

General Provider Information

NPI Number	:	1801460555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATION HEALTHCARE PLLC

Provider Business Mailing Address
First Line	:	7109 FM 2920 RD STE 600
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2218
Country	:	US
Telephone Number	:	832-539-8898
Fax Number	:	866-638-5742

Provider Business Practice Location Address
First Line	:	7109 FM 2920 RD STE 600
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2218
Country	:	US
Telephone Number	:	832-539-8898
Fax Number	:	866-638-5742

Authorized Official
Title or Position	:	CEO
Name	:	MRS. TAMIKA N BEARDEN YOUNG
Credential	:	APRN FNP-C
Telephone Number	:	832-539-8898

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	06/29/2021

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Directions to “FOUNDATION HEALTHCARE PLLC ” Practice Location

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