Individual
CLEMENTINE BI FOKAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21610 STATFIELD GLEN CT, KATY, TX 77450-5674
(281) 763-5464
Mailing address
21610 STATFIELD GLEN CT, KATY, TX 77450-5674
(281) 763-5464
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
30280
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
672392
STATE LICENSE
TX
Enumeration date
06/07/2019
Last updated
06/07/2019
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