Individual
DR. KENNETH FOMULU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-7116
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56277
KY
208M00000X
Hospitalist Physician
Primary
V6170
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2018
Last updated
05/30/2025
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