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Individual
DR. FOMBIN LATEH FONGU
Active
Individual
DR. FOMBIN LATEH FONGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
49302
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49302
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
04/13/2018
Last updated
06/16/2018
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