Fomukong, Justine
Fomukong, Justine is an sole proprietor health care provider with primary practice located at 2739 Cypress Island Dr , Houston TX 77073-1601. She recently has 3 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Nursing Service Related Providers / Personal Care Attendant, Agencies / Home Health. Agencies / Home Health is her primary health care specialty. Fomukong, Justine can be contacted via phone (281) 780-1226.Contact Information
Primary practice address
2739 Cypress Island Dr
Houston TX 77073-1601
Phone: (281) 780-1226
Fax: (281) 857-6729
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Agencies / Day Training, Developmentally Disabled Services | 251C00000X | 017805 | Texas |
Nursing Service Related Providers / Personal Care Attendant | 3747P1801X | 017805 | Texas |
Agencies / Home Health | 251E00000X | 017805 | Texas |
Profile Details
NPI number | 1467836676 |
---|---|
LBN Legal business name | Fomukong, Justine |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 17th, 2015 |
Last updated | Nov 8th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467836676 | NPPES |
Texas | MEDICAID | 367886401 |
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