Individual
CHINELO IKPEAMA FANGTANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MBA
Contact information
Practice address
17903 W LAKE HOUSTON PKWY, HUMBLE, TX 77346
(281) 812-1846
Mailing address
17903 W LAKE HOUSTON PKWY STE 201, HUMBLE, TX 77346-3954
(281) 812-1846
(281) 812-2778
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
BP10050055
TX
207N00000X
Dermatology Physician
Primary
R3534
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R3534
TEXAS MEDICAL LICENSE
TX
Enumeration date
04/23/2014
Last updated
09/30/2021
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