Individual
BEATRICE AMBO FONGE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
301 ANDREWS HWY, MIDLAND, TX 79701-6333
(432) 685-3092
Mailing address
301 ANDREWS HWY, MIDLAND, TX 79701-6333
(432) 685-3092
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
65547
TX
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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