Individual
MELANIE D FOMBANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8484 WILL CLAYTON PKWY, HUMBLE, TX 77338
(832) 995-5200
(832) 995-5219
Mailing address
108 S. WILLIAM BARNETT AVE., CLEVELAND, TX 77327
(281) 592-9775
(281) 592-1570
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP134868
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639165129
—
TX
Enumeration date
09/10/2017
Last updated
01/12/2022
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