Individual
FREDERICH PIEH GBANDAWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
599 UNIVERSITY BLVD APT 410, ROUND ROCK, TX 78665-1084
(713) 474-7443
Mailing address
599 UNIVERSITY BLVD APT 410, ROUND ROCK, TX 78665-1084
(713) 474-7443
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
227646
TX
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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